Provider Demographics
NPI:1902372923
Name:MORRISON, JENNIFER
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MORRISON
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 1:1039 STONERIDGE DR STE 5
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7056
Mailing Address - Country:US
Mailing Address - Phone:406-624-6599
Mailing Address - Fax:888-336-0944
Practice Address - Street 1:1039 STONERIDGE DR STE 5
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7056
Practice Address - Country:US
Practice Address - Phone:406-624-6599
Practice Address - Fax:888-336-0944
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18-68408106S00000X
MT0-19-10016106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician