Doctor Name: | CORNELIA MORRIS |
NPI Number: | 1043682602 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LADC |
License Number: | 001158 |
Business Practice Address: | 12 Crescent St Shelton, CT - 064844103 |
Business Phone Number: | 2035894912 |
Business Fax Number: | |
Mailing Address: | 12 Crescent St, SHELTON |
State: | CT |
Postal Code: | 064844103 |
Phone Number: | 2035894912 |
Fax Number: | |
NPI Enumeration Date: | 10/22/2015 |
NPI Last Update Date: | 10/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 001158 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |