Provider Demographics
NPI:1598031163
Name:MORRIS, CRYSTAL GAYE
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:GAYE
Last Name:MORRIS
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 1:186 SW AMESBURY AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6978
Mailing Address - Country:US
Mailing Address - Phone:305-924-5007
Mailing Address - Fax:
Practice Address - Street 1:186 SW AMESBURY AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6978
Practice Address - Country:US
Practice Address - Phone:305-924-5007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor