Provider Demographics
NPI:1386361467
Name:MORRISON, CHEYENNE (ED S)
Entity type:Individual
Prefix:
First Name:CHEYENNE
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:WY
Mailing Address - Zip Code:82633-2698
Mailing Address - Country:US
Mailing Address - Phone:307-358-6187
Mailing Address - Fax:
Practice Address - Street 1:615 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:WY
Practice Address - Zip Code:82633-2698
Practice Address - Country:US
Practice Address - Phone:307-358-6187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY69946103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool