Healthcare Provider Details

I. General information

NPI: 1013624410
Provider Name (Legal Business Name): IVY SCARLETT MORRISON CD-L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 STONEWOOD CREEK DR
DALLAS GA
30132-9314
US

IV. Provider business mailing address

326 STONEWOOD CREEK DR
DALLAS GA
30132-9314
US

V. Phone/Fax

Practice location:
  • Phone: 678-372-5054
  • Fax:
Mailing address:
  • Phone: 678-372-5054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: