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NPI Code Detail

MEDICARE: ANGELA MORRIS

MEDICARE: ANGELA MORRIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1222Q00000XDevelopmental Therapist

General Provider Information

NPI Number : 1720462492
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MORRIS
Provider Business Mailing Address
First Line : 1101 W OAK AVE
Second Line :
City : JONESBORO
State : AR
Zip : 72401-3814
Country : US
Telephone Number : 870-240-0444
Fax Number : 870-240-0466
Provider Business Practice Location Address
First Line : 6263 HIGHWAY 49 S
Second Line :
City : PARAGOULD
State : AR
Zip : 72450-6093
Country : US
Telephone Number : 870-240-0444
Fax Number : 870-240-0466
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2015
Last Update Date : 07/13/2015

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Directions to “ ANGELA MORRIS ” Practice Location

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