Provider Demographics
NPI:1093559601
Name:MORRIS, JOEL GLENWOOD
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:GLENWOOD
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 BRADLEY AVE
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-3443
Mailing Address - Country:US
Mailing Address - Phone:810-336-4659
Mailing Address - Fax:
Practice Address - Street 1:191 NORTH AVE
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-9703
Practice Address - Country:US
Practice Address - Phone:586-209-3518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician