Basic Information
| Provider Information | |||||||||
| NPI: | 1154931293 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EATON | ||||||||
| FirstName: | MORGANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6303 WATERFORD BLVD STE 260 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731181118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4174599598 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7777 E U.S. RTE 66 | ||||||||
| Address2: | |||||||||
| City: | EL RENO | ||||||||
| State: | OK | ||||||||
| PostalCode: | 73036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4054228800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2020 | ||||||||
| LastUpdateDate: | 05/03/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 10512 | OK | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.