Healthcare Provider Details

I. General information

NPI: 1891612370
Provider Name (Legal Business Name): GINA BENEE MORRIS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PHOENIX BLVD STE 100
ATLANTA GA
30349-6055
US

IV. Provider business mailing address

1521 LEE RD APT 6208
LITHIA SPRINGS GA
30122-3082
US

V. Phone/Fax

Practice location:
  • Phone: 404-429-8227
  • Fax:
Mailing address:
  • Phone: 404-429-8227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT010344
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: