Provider Demographics
NPI:1871969725
Name:DYNES, MORGAN (PHD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:DYNES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3355 GLENDALE AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-2426
Mailing Address - Country:US
Mailing Address - Phone:419-383-5322
Mailing Address - Fax:419-383-6235
Practice Address - Street 1:1400 E MEDICAL LOOP
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-8004
Practice Address - Country:US
Practice Address - Phone:419-383-3861
Practice Address - Fax:419-383-3098
Is Sole Proprietor?:No
Enumeration Date:2015-08-14
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.07605103TC2200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent