Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PS017373 | PA |
NPI | 1013335462 |
---|---|
Provider Name | Dr. Michael Thomas Morrow |
First Address | Media, PA 19063 |
Second Address | Media, PA 19063-2340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2014 |
Last Update Date | 02/04/2014 |