Provider Demographics
NPI:1750973772
Name:MORROW, CONNIE (PHD, PSYCHOLOGIST)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:MORROW
Suffix:
Gender:F
Credentials:PHD, PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13677 MANDARIN CIR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0570
Mailing Address - Country:US
Mailing Address - Phone:239-370-1921
Mailing Address - Fax:
Practice Address - Street 1:5625 STRAND BLVD STE 505
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-7384
Practice Address - Country:US
Practice Address - Phone:352-515-9116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5156103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical