Provider Demographics
NPI:1659792059
Name:COTTER, MORGAN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:COTTER
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 1:99 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PLANDOME
Mailing Address - State:NY
Mailing Address - Zip Code:11030-1455
Mailing Address - Country:US
Mailing Address - Phone:516-996-4382
Mailing Address - Fax:
Practice Address - Street 1:99 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:PLANDOME
Practice Address - State:NY
Practice Address - Zip Code:11030-1455
Practice Address - Country:US
Practice Address - Phone:516-996-4382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-02
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst