MEDICARE: STEPHEN B. MORRIS, PHD, P.C.

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	1143812501	UT

General Provider Information

NPI Number	:	1598725426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN B. MORRIS, PHD, P.C.

Provider Business Mailing Address
First Line	:	3167 LOUISE AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2224
Country	:	US
Telephone Number	:	801-485-2362
Fax Number	:	801-485-1145

Provider Business Practice Location Address
First Line	:	3167 LOUISE AVE
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84109-2224
Country	:	US
Telephone Number	:	801-485-2362
Fax Number	:	801-485-1145

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN B. MORRIS
Credential	:	PHD
Telephone Number	:	801-485-2362

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	08/14/2007

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