Provider Information for 1508115460
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Ms. BETHANY A MORGAN LPC
Other Names:Former Name:Ms. BETHANY TUCKERSex: Female
NPI: 1508115460
Last Updated: 2021-03-26
Certification Date: 2021-03-26
Certification Date: 2021-03-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508115460 | ||||||||
| Enumeration Date | 2012-09-06 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1430 OLIVE ST STE 400 SAINT LOUIS, MO 63103-2303 United States Phone: 314-206-3700 | Fax: | ||||||||
| Primary Practice Address | 1085 MAPLE ST FARMINGTON, MO 63640-1955 United States Phone: 573-747-2446 | Fax: | ||||||||
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