Provider Demographics
NPI:1982469938
Name:MORRIS, KASHALA A (MA, RBT)
Entity Type:Individual
Prefix:
First Name:KASHALA
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 VALENCIA DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5208
Mailing Address - Country:US
Mailing Address - Phone:505-780-9852
Mailing Address - Fax:
Practice Address - Street 1:1810 VALENCIA DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5208
Practice Address - Country:US
Practice Address - Phone:505-780-9852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician