Healthcare Provider Details

I. General information

NPI: 1083225213
Provider Name (Legal Business Name): EMILY GRACE MORRISON MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 08/12/2020
Certification Date: 08/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5604 COLISEUM BLVD STE A
ALEXANDRIA LA
71303-3993
US

IV. Provider business mailing address

226 WILLIAMS AVE
NATCHITOCHES LA
71457-5151
US

V. Phone/Fax

Practice location:
  • Phone: 318-487-5282
  • Fax:
Mailing address:
  • Phone: 318-354-6808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number766
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: