Individual
MINGO MORRISON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1525 N RITTER AVE, INDIANAPOLIS, IN 46219
Mailing address
6626 E 75TH STREET STE 500, INDIANAPOLIS, IN 46250
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34008747A
IN
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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