Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 04476 | MD |
Y | 103G00000X | Clinical Psychologist | 04476 | MD |
Y | 103TC0700X | Clinical Psychologist | 04476 | MD |
NPI | 1154519221 |
---|---|
Provider Name | Dr. Miranda Kendrick Morris |
First Address | Takoma Park, MD 20912-5849 |
Second Address | Bethesda, MD 20814-2425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2007 |
Last Update Date | 14/10/2007 |