Provider Demographics
NPI:1275134066
Name:MORGAN, HYACINTH ANNE
Entity Type:Individual
Prefix:
First Name:HYACINTH
Middle Name:ANNE
Last Name:MORGAN
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 1:7504 NW 70TH TER
Mailing Address - Street 2:
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33321-5101
Mailing Address - Country:US
Mailing Address - Phone:175-421-4397
Mailing Address - Fax:
Practice Address - Street 1:1001 W CYPRESS CREEK RD STE 302S
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-1950
Practice Address - Country:US
Practice Address - Phone:954-271-4797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13297101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health