Provider Demographics
NPI:1285327056
Name:MCMORRIS, BONITA
Entity type:Individual
Prefix:
First Name:BONITA
Middle Name:
Last Name:MCMORRIS
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 1:4 E ROLLING XRDS STE 301
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6279
Mailing Address - Country:US
Mailing Address - Phone:667-802-5335
Mailing Address - Fax:443-860-9756
Practice Address - Street 1:4 E ROLLING XRDS STE 301
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-6279
Practice Address - Country:US
Practice Address - Phone:667-802-5335
Practice Address - Fax:443-860-9756
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management