Provider Demographics
NPI:1407286560
Name:MALM MORGAN, MARIA RITA (PHD IN PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:RITA
Last Name:MALM MORGAN
Suffix:
Gender:F
Credentials:PHD IN PSYCHOLOGY
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Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:2809 MONTCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5766
Mailing Address - Country:US
Mailing Address - Phone:919-688-7101
Mailing Address - Fax:
Practice Address - Street 1:2020 CHAPEL HILL RD STE 23
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1186
Practice Address - Country:US
Practice Address - Phone:919-688-7101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-26
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10309101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional