Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003287772 |
---|---|
Provider Name | Samantha Ashley Morrison |
First Address | Cottondale, FL 32431-3201 |
Second Address | Panama City, FL 32401-1366 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/10/2015 |
Last Update Date | 07/10/2015 |