Healthcare Provider Details

I. General information

NPI: 1356134340
Provider Name (Legal Business Name): MORGAN MCGLONE PSIMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5087 STATE HIGHWAY 955
OLIVE HILL KY
41164-8876
US

IV. Provider business mailing address

5087 STATE HIGHWAY 955
OLIVE HILL KY
41164-8876
US

V. Phone/Fax

Practice location:
  • Phone: 606-316-2720
  • Fax:
Mailing address:
  • Phone: 606-316-2720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: