Healthcare Provider Details

I. General information

NPI: 1982900999
Provider Name (Legal Business Name): JAYNE LAIRD MORRIS OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2011
Last Update Date: 02/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 6TH ST S
ST PETERSBURG FL
33701-4816
US

IV. Provider business mailing address

300 8TH AVE NE
ST PETERSBURG FL
33701-1905
US

V. Phone/Fax

Practice location:
  • Phone: 727-767-4257
  • Fax:
Mailing address:
  • Phone: 727-519-5543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT 13227
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: