Provider Demographics
NPI:1932973757
Name:SMITH, MORGAN LEE
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEE
Last Name:SMITH
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 1:1271 HADLEY CIR UNIT 3204
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-8213
Mailing Address - Country:US
Mailing Address - Phone:502-419-7961
Mailing Address - Fax:
Practice Address - Street 1:1271 HADLEY CIR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-8212
Practice Address - Country:US
Practice Address - Phone:150-241-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst