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General NPI Number Information
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NPI Number | 1598454571
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Entity Type | Individual
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Provider Name | OLLISSEA MORGANFIELD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 13600 WIMBLEDON LOOP APT C311
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City | LITTLE ROCK
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State | AR
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Zip | 72210-6125
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Country | US
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Telephone | 662-820-6887
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Fax |
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Provider Business Mailing Address
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Address Line | 13600 WIMBLEDON LOOP APT C311
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City | LITTLE ROCK
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State | AR
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Zip | 72210-6125
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Country | US
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Telephone | 662-820-6887
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 202482
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 14283865
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License Number State | MS
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