Healthcare Provider Details

I. General information

NPI: 1578481990
Provider Name (Legal Business Name): MORGAN MINTER FITZGERALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10715 SPOTSYLVANIA AVE
FREDERICKSBURG VA
22408-2674
US

IV. Provider business mailing address

10715 SPOTSYLVANIA AVE
FREDERICKSBURG VA
22408-2674
US

V. Phone/Fax

Practice location:
  • Phone: 540-809-0082
  • Fax:
Mailing address:
  • Phone: 540-809-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0134000245
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: