MEDICARE: SARA MORRISON CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SLP010661	GA

General Provider Information

NPI Number	:	1376319939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARA MORRISON CCC-SLP

Provider Business Mailing Address
First Line	:	361 17TH ST NW UNIT 1205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1084
Country	:	US
Telephone Number	:	912-230-6331
Fax Number	:

Provider Business Practice Location Address
First Line	:	361 17TH ST NW UNIT 1205
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30363-1084
Country	:	US
Telephone Number	:	912-230-6331
Fax Number	:

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

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	11/27/2023

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Directions to “ SARA MORRISON CCC-SLP” Practice Location

Language	Start Address	Practice Location

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