MEDICARE: OLIVE DOROTHY MORROW

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1386714780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLIVE DOROTHY MORROW

Provider Business Mailing Address
First Line	:	3205 W CAPITOL AVE
Second Line	:	APT C
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-2130
Country	:	US
Telephone Number	:	916-371-3253
Fax Number	:

Provider Business Practice Location Address
First Line	:	3205 W CAPITOL AVE
Second Line	:	APT C
City	:	WEST SACRAMENTO
State	:	CA
Zip	:	95691-2130
Country	:	US
Telephone Number	:	916-371-3253
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	07/08/2007

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