Provider Demographics
NPI:1477025211
Name:MORRIS, STEFANI ANN (PSYD)
Entity Type:Individual
Prefix:
First Name:STEFANI
Middle Name:ANN
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:STEFANI
Other - Middle Name:ANN
Other - Last Name:VERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:48 S 230TH AVE
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-6259
Mailing Address - Country:US
Mailing Address - Phone:206-384-5030
Mailing Address - Fax:
Practice Address - Street 1:3400 N DYSART RD # 117
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-1003
Practice Address - Country:US
Practice Address - Phone:623-536-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ005060103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical