Provider Demographics
NPI:1477938843
Name:WOELLER, MORGAN
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:WOELLER
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 1:5297 S 31ST ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-3512
Mailing Address - Country:US
Mailing Address - Phone:254-228-5830
Mailing Address - Fax:512-532-0806
Practice Address - Street 1:5297 S 31ST ST
Practice Address - Street 2:SUITE 113
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3512
Practice Address - Country:US
Practice Address - Phone:254-228-5830
Practice Address - Fax:512-532-0806
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX68699101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional