Provider Demographics
NPI:1417333170
Name:MCGOWAN, MORGAN GRAY (PHD)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:GRAY
Last Name:MCGOWAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TENNIE
Other - Middle Name:MORGAN
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 964
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-0964
Mailing Address - Country:US
Mailing Address - Phone:479-477-2352
Mailing Address - Fax:
Practice Address - Street 1:2013 N GREEN ACRES RD STE C
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2600
Practice Address - Country:US
Practice Address - Phone:479-477-2352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-05
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor