Provider Demographics
NPI:1114384484
Name:MORRIS, CHIUNA STACEY
Entity Type:Individual
Prefix:
First Name:CHIUNA
Middle Name:STACEY
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 1:409 KENDALL LAKE DR
Mailing Address - Street 2:APT 204
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33510-2369
Mailing Address - Country:US
Mailing Address - Phone:516-642-2598
Mailing Address - Fax:
Practice Address - Street 1:409 KENDALL LAKE DR
Practice Address - Street 2:APT 204
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33510-2369
Practice Address - Country:US
Practice Address - Phone:516-642-2598
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst