Doctor Name: | KENT MORRISON |
NPI Number: | 1114341690 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LAADC-R, CADC II |
License Number: | LR140311 |
Business Practice Address: | 7996 Old Winding Way Ste 300 Fair Oaks, CA - 956287159 |
Business Phone Number: | 9169664523 |
Business Fax Number: | 9169664599 |
Mailing Address: | 7996 Old Winding Way Ste 300, FAIR OAKS |
State: | CA |
Postal Code: | 956287159 |
Phone Number: | 9169664523 |
Fax Number: | 9169664599 |
NPI Enumeration Date: | 02/05/2014 |
NPI Last Update Date: | 02/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | LR140311 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |