Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 031148 | CT |
Y | 103TP0016X | Prescribing (Medical) | 031148 | CT |
NPI | 1164859963 |
---|---|
Provider Name | Dr. Charles Alexander Morgan III |
First Address | New Haven, CT 06510-1807 |
Second Address | New Haven, CT 06510-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2013 |
Last Update Date | 11/10/2013 |