Provider Demographics
NPI:1598491458
Name:MORRISON, KYRA MAY
Entity Type:Individual
Prefix:
First Name:KYRA
Middle Name:MAY
Last Name:MORRISON
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 1:15A ROSIN CUP CIR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459-7117
Mailing Address - Country:US
Mailing Address - Phone:410-440-1866
Mailing Address - Fax:
Practice Address - Street 1:327 S COUNTY HIGHWAY 393 UNIT 201
Practice Address - Street 2:
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459-8209
Practice Address - Country:US
Practice Address - Phone:850-290-2246
Practice Address - Fax:850-502-8091
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW175161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical