Provider Demographics
NPI:1497427769
Name:MORRIS, DORTHINA DEMEATRIA (AMFT)
Entity Type:Individual
Prefix:
First Name:DORTHINA
Middle Name:DEMEATRIA
Last Name:MORRIS
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 W SHAW AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-3308
Mailing Address - Country:US
Mailing Address - Phone:559-290-7142
Mailing Address - Fax:
Practice Address - Street 1:2549 W SHAW AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3308
Practice Address - Country:US
Practice Address - Phone:559-290-7142
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-04
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA128367101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health