Provider Demographics
NPI:1992092613
Name:MORALES, REBECA M (LADC II)
Entity type:Individual
Prefix:MS
First Name:REBECA
Middle Name:M
Last Name:MORALES
Suffix:
Gender:F
Credentials:LADC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:131 BEVERLY ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2118
Mailing Address - Country:US
Mailing Address - Phone:617-720-0152
Mailing Address - Fax:617-367-9644
Practice Address - Street 1:131 BEVERLY ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2118
Practice Address - Country:US
Practice Address - Phone:617-720-0153
Practice Address - Fax:617-367-9644
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)