MEDICARE: HEATHER MORMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251C00000X	Developmentally Disabled Services Day Training Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215656640
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MORMAN

Provider Business Mailing Address
First Line	:	915 N COLUMBUS ST REAR
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-1734
Country	:	US
Telephone Number	:	561-876-8500
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 N COLUMBUS ST REAR
Second Line	:
City	:	LANCASTER
State	:	OH
Zip	:	43130-1734
Country	:	US
Telephone Number	:	561-876-8500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	08/29/2022

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Directions to “ HEATHER MORMAN ” Practice Location

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