Provider Demographics
NPI:1790839389
Name:MORRIS, DAVID (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6381 OSGOOD AVE N
Mailing Address - Street 2:BUILDING C
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-6118
Mailing Address - Country:US
Mailing Address - Phone:651-439-4040
Mailing Address - Fax:651-439-7368
Practice Address - Street 1:6381 OSGOOD AVE N
Practice Address - Street 2:BUILDING C
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-6118
Practice Address - Country:US
Practice Address - Phone:651-439-4040
Practice Address - Fax:651-439-7368
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0743103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical