Provider Demographics
NPI:1730954892
Name:MORRIS, BANDALENA CHRISTINE
Entity type:Individual
Prefix:
First Name:BANDALENA
Middle Name:CHRISTINE
Last Name:MORRIS
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 1:317 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:AL
Mailing Address - Zip Code:36027-2521
Mailing Address - Country:US
Mailing Address - Phone:334-695-0224
Mailing Address - Fax:
Practice Address - Street 1:317 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:AL
Practice Address - Zip Code:36027-2521
Practice Address - Country:US
Practice Address - Phone:334-695-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-23-311240106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician