MEDICARE: DEANNA MORROW BCBA

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	103K00000X	Behavior Analyst	L-179	LA

General Provider Information

NPI Number	:	1538611892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNA MORROW BCBA

Provider Business Mailing Address
First Line	:	PO BOX 1823
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71294-1823
Country	:	US
Telephone Number	:	318-588-8908
Fax Number	:	318-588-8909

Provider Business Practice Location Address
First Line	:	201 COMMERCIAL CIR
Second Line	:	SUITE B
City	:	WEST MONROE
State	:	LA
Zip	:	71292-8073
Country	:	US
Telephone Number	:	318-588-8908
Fax Number	:	318-588-8909

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

Provider Enumeration Date	:	11/02/2016
Last Update Date	:	11/02/2016

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