Provider Demographics
NPI:1710014840
Name:MORRISON, ANTOINETTE B (MA)
Entity Type:Individual
Prefix:MS
First Name:ANTOINETTE
Middle Name:B
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 330R
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-9711
Mailing Address - Country:US
Mailing Address - Phone:304-546-9214
Mailing Address - Fax:304-343-0057
Practice Address - Street 1:RR 2 BOX 330R
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-9711
Practice Address - Country:US
Practice Address - Phone:304-546-9214
Practice Address - Fax:304-343-0057
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional