Provider Demographics
NPI:1750751129
Name:MORROW, WAVA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:WAVA
Middle Name:MARIE
Last Name:MORROW
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 HACKBERRY DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-3605
Mailing Address - Country:US
Mailing Address - Phone:563-528-2425
Mailing Address - Fax:
Practice Address - Street 1:202 E LOCUST ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1832
Practice Address - Country:US
Practice Address - Phone:563-528-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015032867101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional