Provider Demographics
NPI:1528197373
Name:MORRIS, MAXINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAXINE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 SW 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-5894
Mailing Address - Country:US
Mailing Address - Phone:239-542-0718
Mailing Address - Fax:
Practice Address - Street 1:4116 SW 5TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-5894
Practice Address - Country:US
Practice Address - Phone:239-542-0718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)