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General NPI Number Information
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NPI Number | 1053063180
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Entity Type | Individual
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Provider Name | TAYSUE ETHEL MORRIS
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 17904 GEORGIA AVE
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City | OLNEY
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State | MD
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Zip | 20832-2239
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Country | US
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Telephone | 240-304-3327
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Fax |
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Provider Business Mailing Address
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Address Line | 18500 OWL RUN WAY
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City | GERMANTOWN
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State | MD
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Zip | 20874-2105
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Country | US
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Telephone | 240-848-0533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LGP11718
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License Number State | MD
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