Provider Demographics
NPI:1083852800
Name:MORGAN, KATHERINE GRACE (MS)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GRACE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 WIMBLEDON CT
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-3460
Mailing Address - Country:US
Mailing Address - Phone:580-222-9027
Mailing Address - Fax:
Practice Address - Street 1:2200 WIMBLEDON CT
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-3460
Practice Address - Country:US
Practice Address - Phone:580-222-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4441101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health