MEDICARE: DR. SUSAN WINSLOW MORRIS PH.D.

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	103TC0700X	Clinical Psychologist	PSY000524	GA

General Provider Information

NPI Number	:	1225040108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN WINSLOW MORRIS PH.D.

Provider Business Mailing Address
First Line	:	2785 LAWRENCEVILLE HWY
Second Line	:	SUITE 108
City	:	DECATUR
State	:	GA
Zip	:	30033-2515
Country	:	US
Telephone Number	:	770-270-5488
Fax Number	:	770-270-8876

Provider Business Practice Location Address
First Line	:	2785 LAWRENCEVILLE HWY
Second Line	:	SUITE 108
City	:	DECATUR
State	:	GA
Zip	:	30033-2515
Country	:	US
Telephone Number	:	770-270-5488
Fax Number	:	770-270-8876

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

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/08/2007

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