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General NPI Number Information
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NPI Number | 1740637057
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Entity Type | Individual
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Provider Name | BREANNA MORRIS MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2016
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 15800 NEABSCO RD
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City | WOODBRIDGE
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State | VA
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Zip | 22191-4505
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Country | US
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Telephone | 703-670-8268
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Fax |
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Provider Business Mailing Address
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Address Line | 11999 COVERSTONE HILL CIR APT 611
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City | MANASSAS
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State | VA
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Zip | 20109-7519
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Country | US
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Telephone | 570-947-7973
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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 | SL012611
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License Number State | PA
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