Individual
DR. RAFAEL MORA DE JESUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
210 WETHERSFIELD AVE, HARTFORD, CT 06114-1113
(860) 296-0094
(860) 206-1184
Mailing address
210 WETHERSFIELD AVE, HARTFORD, CT 06114-1113
(860) 296-0094
(860) 206-1184
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
001877
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004132700
—
CT
Enumeration date
12/13/2006
Last updated
07/02/2014
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