Provider Demographics
NPI:1396578167
Name:MORRISON, JESSICA (EDS)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7161 STUDLEY RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-6514
Mailing Address - Country:US
Mailing Address - Phone:804-723-3591
Mailing Address - Fax:804-723-3594
Practice Address - Street 1:7161 STUDLEY RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-6514
Practice Address - Country:US
Practice Address - Phone:804-723-3591
Practice Address - Fax:804-723-3594
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAPPS-0600428103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool