Provider Demographics
NPI:1730889502
Name:MORTON, KYLE FRANK (PHD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:FRANK
Last Name:MORTON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4753 ALTAMA PL
Mailing Address - Street 2:
Mailing Address - City:LIZELLA
Mailing Address - State:GA
Mailing Address - Zip Code:31052-4517
Mailing Address - Country:US
Mailing Address - Phone:478-361-7815
Mailing Address - Fax:
Practice Address - Street 1:2152 ZION HL
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8847
Practice Address - Country:US
Practice Address - Phone:478-361-7815
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-09
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No172A00000XOther Service ProvidersDriver