Provider Demographics
NPI:1104990324
Name:MORRIS, JUTTA MARIA (MA)
Entity type:Individual
Prefix:MRS
First Name:JUTTA
Middle Name:MARIA
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-4709
Mailing Address - Country:US
Mailing Address - Phone:561-317-7389
Mailing Address - Fax:561-741-8000
Practice Address - Street 1:1 MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-4709
Practice Address - Country:US
Practice Address - Phone:561-317-7389
Practice Address - Fax:561-741-8000
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH9199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health