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NPI Code Detail

MEDICARE: MORGAN BLAISE HOWERTON

MEDICARE: MORGAN BLAISE HOWERTON
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 Technician

General Provider Information

NPI Number : 1770044257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORGAN BLAISE HOWERTON
Provider Business Mailing Address
First Line : 4600 FOREST HILL AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23225-3246
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 FOREST HILL AVE
Second Line :
City : RICHMOND
State : VA
Zip : 23225-3246
Country : US
Telephone Number : 804-489-7364
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2019
Last Update Date : 03/27/2019

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