Provider Demographics
NPI:1346048022
Name:MORROW, ISHMEL
Entity type:Individual
Prefix:
First Name:ISHMEL
Middle Name:
Last Name:MORROW
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9480 THREE RIVERS RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4248
Mailing Address - Country:US
Mailing Address - Phone:251-648-4346
Mailing Address - Fax:
Practice Address - Street 1:9480 THREE RIVERS RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4248
Practice Address - Country:US
Practice Address - Phone:251-648-4346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician