Provider Demographics
NPI:1770915167
Name:LOCKE, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:LOCKE
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 1:1325 BAGBY AVE
Mailing Address - Street 2:APT. E
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-8601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1325 BAGBY AVE
Practice Address - Street 2:APT. E
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-8601
Practice Address - Country:US
Practice Address - Phone:832-293-3185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-07
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst