MEDICARE: MRS. HAYLIE MARIE MORRIS MS CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	106403	TX

General Provider Information

NPI Number	:	1902151798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HAYLIE MARIE MORRIS MS CCC-SLP

Provider Business Mailing Address
First Line	:	1111 W SHORE DR
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75080-4046
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5720 LBJ FWY
Second Line	:	SUITE 550
City	:	DALLAS
State	:	TX
Zip	:	75240-6328
Country	:	US
Telephone Number	:	817-239-4419
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	07/17/2012

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