Healthcare Provider Details

I. General information

NPI: 1265508501
Provider Name (Legal Business Name): MRS. EDITH RAVAE MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 S EXETER ST FL 2
BALTIMORE MD
21202-4365
US

IV. Provider business mailing address

PO BOX 6397
CHANDLER AZ
85246
US

V. Phone/Fax

Practice location:
  • Phone: 888-260-4159
  • Fax:
Mailing address:
  • Phone: 480-820-6366
  • Fax: 480-820-0462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP4170
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: