Provider Demographics
NPI:1861830028
Name:GAWRILUK, MORGAN LACY
Entity Type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:LACY
Last Name:GAWRILUK
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 1:1406 HAYS ST
Mailing Address - Street 2:SUIT 8
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-2833
Mailing Address - Country:US
Mailing Address - Phone:850-521-0242
Mailing Address - Fax:
Practice Address - Street 1:3208 GULF BREEZE PKWY
Practice Address - Street 2:
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32563-3350
Practice Address - Country:US
Practice Address - Phone:800-676-5130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst