Basic Information
| Provider Information | |||||||||
| NPI: | 1295134120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORROW | ||||||||
| FirstName: | SHANNON | ||||||||
| MiddleName: | KYLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 W MOANA LN | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895094775 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753372394 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1101 W. MOANA LN | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 89509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753372394 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/15/2014 | ||||||||
| LastUpdateDate: | 09/24/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 106H00000X | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.