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NPI Code Detail

MEDICARE: MORGAN CHRISTENE ICENHOWER

MEDICARE: MORGAN CHRISTENE ICENHOWER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-23-291297TX

General Provider Information

NPI Number : 1255296968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN CHRISTENE ICENHOWER
Provider Business Mailing Address
First Line : 2220 H G MOSLEY PKWY
Second Line :
City : LONGVIEW
State : TX
Zip : 75604-3663
Country : US
Telephone Number : 903-353-9247
Fax Number : 317-334-7336
Provider Business Practice Location Address
First Line : 2700 COMMERCE WAY STE 400
Second Line :
City : KAUFMAN
State : TX
Zip : 75142-7362
Country : US
Telephone Number : 469-804-6153
Fax Number : 317-334-7336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/16/2025
Last Update Date : 05/26/2026

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Directions to “ MORGAN CHRISTENE ICENHOWER ” Practice Location

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