Provider Demographics
NPI:1174555817
Name:MORRICE-MCBRIDE, AMANDA VERA (PSYD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:VERA
Last Name:MORRICE-MCBRIDE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2503
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78403-2503
Mailing Address - Country:US
Mailing Address - Phone:361-883-1219
Mailing Address - Fax:361-887-1080
Practice Address - Street 1:101 N SHORELINE BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78401-2824
Practice Address - Country:US
Practice Address - Phone:361-883-1219
Practice Address - Fax:361-887-1080
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30571103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87518AOtherBC/BS PROVIDER NUMBER
TX1027534-06Medicaid
TX1027534-06Medicaid
TX87518AOtherBC/BS PROVIDER NUMBER