Provider Demographics
NPI:1013373430
Name:MORRIS, TYLER
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47154 KROGEN KOVE LOOP
Mailing Address - Street 2:APT A
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-6737
Mailing Address - Country:US
Mailing Address - Phone:985-707-7071
Mailing Address - Fax:
Practice Address - Street 1:47154 KROGEN KOVE LOOP
Practice Address - Street 2:APT A
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-6737
Practice Address - Country:US
Practice Address - Phone:985-707-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health