Provider Demographics
NPI:1578990511
Name:DILLINGHAM, MORGAN
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:DILLINGHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:DILLINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:OK
Mailing Address - Zip Code:73541-0303
Mailing Address - Country:US
Mailing Address - Phone:580-927-5798
Mailing Address - Fax:
Practice Address - Street 1:303 W SHIELDS AVE
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OK
Practice Address - Zip Code:73541-0303
Practice Address - Country:US
Practice Address - Phone:580-927-5798
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-06
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst