Provider Demographics
NPI:1750157798
Name:LARISON, MORGAN LEE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEE
Last Name:LARISON
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 1:1540 ANDERSON RD
Mailing Address - Street 2:
Mailing Address - City:DE MOSSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41033-9512
Mailing Address - Country:US
Mailing Address - Phone:859-638-0961
Mailing Address - Fax:
Practice Address - Street 1:1540 ANDERSON RD
Practice Address - Street 2:
Practice Address - City:DE MOSSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41033-9512
Practice Address - Country:US
Practice Address - Phone:859-638-0961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator