Provider Demographics
NPI:1336479864
Name:MORGAN, JAIME L (MED, LPC CANDIDATE)
Entity Type:Individual
Prefix:
First Name:JAIME
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MED, LPC CANDIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 378
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954-0378
Mailing Address - Country:US
Mailing Address - Phone:918-427-1311
Mailing Address - Fax:918-427-0013
Practice Address - Street 1:100 E RAY FINE BLVD
Practice Address - Street 2:
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954-5198
Practice Address - Country:US
Practice Address - Phone:918-427-1311
Practice Address - Fax:918-427-0013
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor