Provider Demographics
NPI:1770061749
Name:MORRISON, ANGELA K
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:K
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 1:108 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1776
Mailing Address - Country:US
Mailing Address - Phone:269-377-4181
Mailing Address - Fax:269-204-6022
Practice Address - Street 1:108 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1776
Practice Address - Country:US
Practice Address - Phone:269-377-4181
Practice Address - Fax:269-204-6022
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-01
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014307103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling