Healthcare Provider Details

I. General information

NPI: 1134035074
Provider Name (Legal Business Name): SHAKERRIAH DANIELLE MORGAN LMBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S ROAD ST
ELIZABETH CITY NC
27909-4355
US

IV. Provider business mailing address

111 S ROAD ST
ELIZABETH CITY NC
27909-4355
US

V. Phone/Fax

Practice location:
  • Phone: 445-214-4644
  • Fax:
Mailing address:
  • Phone: 445-214-4644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number23311
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: