MEDICARE: DR. ROBERT D MORRISSEY PHD

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	103T00000X	Psychologist	06-25	AR

General Provider Information

NPI Number	:	1346331642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT D MORRISSEY PHD

Provider Business Mailing Address
First Line	:	125 PARK PLACE DRIVE
Second Line	:
City	:	HOLLISTER
State	:	MO
Zip	:	65672
Country	:	US
Telephone Number	:	417-300-3532
Fax Number	:

Provider Business Practice Location Address
First Line	:	4350 S NATIONAL AVE
Second Line	:	SUITE B-116
City	:	SPRINGFIELD
State	:	MO
Zip	:	65810-2607
Country	:	US
Telephone Number	:	417-881-1810
Fax Number	:

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

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	08/07/2008

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