Provider Demographics
NPI:1679081194
Name:O'HERN, MORGAN MARIE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:MARIE
Last Name:O'HERN
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 1:2801 S GLASS ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-3309
Mailing Address - Country:US
Mailing Address - Phone:712-301-4618
Mailing Address - Fax:
Practice Address - Street 1:2801 S GLASS ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-3309
Practice Address - Country:US
Practice Address - Phone:712-301-4618
Practice Address - Fax:712-301-4618
Is Sole Proprietor?:No
Enumeration Date:2018-01-18
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)