Healthcare Provider Details

I. General information

NPI: 1023101102
Provider Name (Legal Business Name): BONNIE JEANNE MORROW SOCIAL WORKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W 10TH ST
INDIANAPOLIS IN
46202-2803
US

IV. Provider business mailing address

118 E COLLEGE AVE
BROWNSBURG IN
46112-1207
US

V. Phone/Fax

Practice location:
  • Phone: 317-988-2660
  • Fax: 317-988-3243
Mailing address:
  • Phone: 317-443-5912
  • Fax: 317-988-3243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number33004974A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: