Provider Demographics
NPI:1669974283
Name:WILLIAMSON, MORGAN LEIGH
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LEIGH
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6867 SOUTHPOINT DR N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-8043
Mailing Address - Country:US
Mailing Address - Phone:904-619-6071
Mailing Address - Fax:904-212-0309
Practice Address - Street 1:6867 SOUTHPOINT DR N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8043
Practice Address - Country:US
Practice Address - Phone:904-619-6071
Practice Address - Fax:904-212-0309
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician