Healthcare Provider Details

I. General information

NPI: 1487138368
Provider Name (Legal Business Name): KRISTI KAY MORROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 11/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 FRANKFORT HWY
BENZONIA MI
49616-9558
US

IV. Provider business mailing address

310 GLOCHESKI DR
MANISTEE MI
49660-2639
US

V. Phone/Fax

Practice location:
  • Phone: 877-398-2013
  • Fax: 231-882-2360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801103013
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: