Provider Demographics
NPI:1194267401
Name:MORRIS, TIA K
Entity type:Individual
Prefix:
First Name:TIA
Middle Name:K
Last Name:MORRIS
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 1:343 W FIRETOWER RD
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9444
Mailing Address - Country:US
Mailing Address - Phone:870-406-4705
Mailing Address - Fax:870-406-4725
Practice Address - Street 1:343 W FIRETOWER RD
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542-9444
Practice Address - Country:US
Practice Address - Phone:870-406-4705
Practice Address - Fax:870-406-4725
Is Sole Proprietor?:No
Enumeration Date:2016-11-17
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1901002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional