MEDICARE: DR. JENNIFER MORGAN PSYD

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	103TC0700X	Clinical Psychologist	6142	OH

General Provider Information

NPI Number	:	1427099092
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER MORGAN PSYD

Provider Business Mailing Address
First Line	:	11034 BANCROFT AVE NW
Second Line	:
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-8686
Country	:	US
Telephone Number	:	330-575-7096
Fax Number	:	330-896-0887

Provider Business Practice Location Address
First Line	:	1790 TOWN PARK BLVD
Second Line	:	SUITE C
City	:	UNIONTOWN
State	:	OH
Zip	:	44685-7972
Country	:	US
Telephone Number	:	330-575-7096
Fax Number	:	330-896-0887

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	02/14/2011

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