Provider Demographics
NPI:1356816912
Name:MORROW, BRENDA LEA
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:LEA
Last Name:MORROW
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 1:101 N KEYSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5901
Mailing Address - Country:US
Mailing Address - Phone:512-801-2148
Mailing Address - Fax:
Practice Address - Street 1:317 W CHEROKEE AVE STE B
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-5616
Practice Address - Country:US
Practice Address - Phone:580-297-5125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health