Provider Demographics
NPI:1174091391
Name:MORALES HERRERA, JANETTE ADRIANA
Entity type:Individual
Prefix:MISS
First Name:JANETTE
Middle Name:ADRIANA
Last Name:MORALES HERRERA
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 1:2215 NW CACHE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5258
Mailing Address - Country:US
Mailing Address - Phone:580-351-9998
Mailing Address - Fax:580-351-9898
Practice Address - Street 1:2215 NW CACHE RD STE 107
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5258
Practice Address - Country:US
Practice Address - Phone:580-351-9998
Practice Address - Fax:580-351-9898
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor