Provider Demographics
NPI:1578385514
Name:MORGAN, NICOLE FRANCES
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:FRANCES
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:983 ALMA RD
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32433-0925
Mailing Address - Country:US
Mailing Address - Phone:850-520-0231
Mailing Address - Fax:888-545-1603
Practice Address - Street 1:1846 US HIGHWAY 90 W STE B
Practice Address - Street 2:
Practice Address - City:DEFUNIAK SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32433-1408
Practice Address - Country:US
Practice Address - Phone:850-419-5061
Practice Address - Fax:888-545-1603
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-373032103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst