Healthcare Provider Details

I. General information

NPI: 1144083932
Provider Name (Legal Business Name): KIMBERLY MORRISON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 E WASHINGTON ST STE 300
PHOENIX AZ
85034-1908
US

IV. Provider business mailing address

19557 KIKER RD
WINNIE TX
77665-8239
US

V. Phone/Fax

Practice location:
  • Phone: 623-335-4283
  • Fax: 623-748-1919
Mailing address:
  • Phone: 757-971-3114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: