Provider Demographics
NPI:1164127726
Name:KENT, MORGAN (MS, BCBA, LBA)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:KENT
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 BISHOP GARDNER RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:MS
Mailing Address - Zip Code:38856-5871
Mailing Address - Country:US
Mailing Address - Phone:662-554-9972
Mailing Address - Fax:
Practice Address - Street 1:1040 CLIFF GOOKIN BLVD STE H
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6467
Practice Address - Country:US
Practice Address - Phone:662-205-4375
Practice Address - Fax:662-584-2990
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSBACB379080103K00000X
MS1-23-64023103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst