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General NPI Number Information
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NPI Number | 1376993410
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Entity Type | Individual
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Provider Name | BETH MORRIS L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2016
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 1110 W B ST
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City | RUSSELLVILLE
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State | AR
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Zip | 72801-3506
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Country | US
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Telephone | 479-970-0630
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Fax |
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Provider Business Mailing Address
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Address Line | 156 MARIE DR
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City | POTTSVILLE
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State | AR
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Zip | 72858-8737
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Country | US
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Telephone | 479-970-0630
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | P9506018
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License Number State | AR
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