Provider Demographics
NPI:1003242058
Name:MORRIS, TIA
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 N MACARTHUR BLVD
Mailing Address - Street 2:APT 2309
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73142-3032
Mailing Address - Country:US
Mailing Address - Phone:580-402-3926
Mailing Address - Fax:
Practice Address - Street 1:12401 N MACARTHUR BLVD
Practice Address - Street 2:APT 2309
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-3032
Practice Address - Country:US
Practice Address - Phone:580-402-3926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst