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General NPI Number Information
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NPI Number | 1710705462
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Entity Type | Individual
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Provider Name | JESSICA Y MORTON MA
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Gender | Female
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Dates
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Enumeration Date | 10/01/2024
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Last Update Date | 10/01/2024
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Provider Practice Location Address
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Address Line | 1118 ARBOR VIEW CIR
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City | DIBERVILLE
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State | MS
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Zip | 39540-4843
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Country | US
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Telephone | 601-941-5320
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S BROAD ST
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City | NEW ORLEANS
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State | LA
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Zip | 70119-6447
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Country | US
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Telephone | 504-309-9991
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Fax | 504-900-8555
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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