Healthcare Provider Details

I. General information

NPI: 1790505105
Provider Name (Legal Business Name): HEATHER MORTON LPC-ASSOCIATE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 METHVEN LN
RENO TX
75462-7222
US

IV. Provider business mailing address

160 METHVEN LN
RENO TX
75462-7222
US

V. Phone/Fax

Practice location:
  • Phone: 903-517-0497
  • Fax:
Mailing address:
  • Phone: 903-517-0497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number95089
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: