Provider Demographics
NPI:1154065860
Name:OBRIEN, MORGAN COLLEEN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:COLLEEN
Last Name:OBRIEN
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 1:729 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-1643
Mailing Address - Country:US
Mailing Address - Phone:937-642-9555
Mailing Address - Fax:
Practice Address - Street 1:729 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-1643
Practice Address - Country:US
Practice Address - Phone:937-642-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist