Provider Demographics
NPI:1164187126
Name:HEISER, MORGAN ELIZABETH (MS, BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:HEISER
Suffix:
Gender:F
Credentials:MS, BCBA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4602 CANTON ST UNIT 307
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-2072
Mailing Address - Country:US
Mailing Address - Phone:609-731-7690
Mailing Address - Fax:
Practice Address - Street 1:77 W BALTIMORE PIKE STE 100B
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5639
Practice Address - Country:US
Practice Address - Phone:610-580-0264
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-23-70454103K00000X
PABH006103103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst