Healthcare Provider Details

I. General information

NPI: 1548581804
Provider Name (Legal Business Name): HEATHER RIEGEL MORRISON AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 04/26/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 AMALIA STREET NE
CONCORD NC
28025-2434
US

IV. Provider business mailing address

6035 FAIRVIEW RD
CHARLOTTE NC
28210-3256
US

V. Phone/Fax

Practice location:
  • Phone: 704-295-3255
  • Fax: 704-295-3279
Mailing address:
  • Phone: 704-295-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number9039
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: