Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 161598 | OH |
NPI | 1003319211 |
---|---|
Provider Name | Cheryl Lyn Morris |
First Address | Athens, OH 45701-1334 |
Second Address | Jackson, OH 45640-9360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2018 |
Last Update Date | 16/06/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2864002 | (05) | OH |