Healthcare Provider Details

I. General information

NPI: 1205791951
Provider Name (Legal Business Name): MORGANN KIDWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2224 N CRAYCROFT RD
TUCSON AZ
85712-2811
US

IV. Provider business mailing address

2850 N COUNTRY CLUB RD
TUCSON AZ
85716-1910
US

V. Phone/Fax

Practice location:
  • Phone: 520-896-1400
  • Fax: 520-614-6050
Mailing address:
  • Phone: 520-322-6274
  • Fax: 520-509-4496

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT-16463
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: