Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103TC1900X | Counseling Psychologist | 1013288224 | OR |
NPI | 1013288224 |
---|---|
Provider Name | Maxwell James Morris |
First Address | Eugene, OR 97401-3979 |
Second Address | Eugene, OR 97401-3570 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2012 |
Last Update Date | 14/08/2017 |