Provider Demographics
NPI:1407587140
Name:WILLIAMS, MORGAN ROCHELLE (CCSH, RPSGT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ROCHELLE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CCSH, RPSGT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3930 ARBOR TRACE DR UNIT A
Mailing Address - Street 2:
Mailing Address - City:LYNN HAVEN
Mailing Address - State:FL
Mailing Address - Zip Code:32444-6717
Mailing Address - Country:US
Mailing Address - Phone:850-867-0409
Mailing Address - Fax:
Practice Address - Street 1:502 N MACARTHUR AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3654
Practice Address - Country:US
Practice Address - Phone:850-769-1797
Practice Address - Fax:850-215-2185
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL577261QS1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic