Provider Demographics
NPI:1013556760
Name:ACOSTA, MORGAN A
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:A
Last Name:ACOSTA
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 1:2132 ALTURA VERDE LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5066
Mailing Address - Country:US
Mailing Address - Phone:505-800-9854
Mailing Address - Fax:
Practice Address - Street 1:2132 ALTURA VERDE LN NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5066
Practice Address - Country:US
Practice Address - Phone:505-800-9854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-29
Last Update Date:2019-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician