Provider Demographics
NPI:1467842625
Name:MORRIS, JODIE
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:MORRIS
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 1:222 N DUCK ST
Mailing Address - Street 2:APT 120
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-7519
Mailing Address - Country:US
Mailing Address - Phone:405-201-5590
Mailing Address - Fax:
Practice Address - Street 1:222 N DUCK ST
Practice Address - Street 2:APT 120
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-7519
Practice Address - Country:US
Practice Address - Phone:405-201-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-27
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst