Provider Demographics
NPI:1821790411
Name:OBREGON, MORGAN AUTUMN
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:AUTUMN
Last Name:OBREGON
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 1:2800 LEXINGTON PL NE APT 3
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-1365
Mailing Address - Country:US
Mailing Address - Phone:505-856-6880
Mailing Address - Fax:
Practice Address - Street 1:2800 LEXINGTON PL NE APT 3
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-1365
Practice Address - Country:US
Practice Address - Phone:575-642-8690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician