Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 33000170A | IN |
NPI | 1003069303 |
---|---|
Provider Name | Melissa Ann Morse |
First Address | Michigan City, IN 46360 |
Second Address | Michigan City, IN 46360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2008 |
Last Update Date | 30/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100163580A | (05) | IN |