Provider Demographics
NPI:1023795275
Name:MORALES, LOURDES
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 S DAHLIA ST APT 103
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-2677
Mailing Address - Country:US
Mailing Address - Phone:720-292-7928
Mailing Address - Fax:
Practice Address - Street 1:931 S DAHLIA ST APT 103
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-2677
Practice Address - Country:US
Practice Address - Phone:720-292-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator