MEDICARE: MARY JO MORRISON 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	1336	AR

General Provider Information

NPI Number	:	1598902157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY JO MORRISON SLP

Provider Business Mailing Address
First Line	:	280 RIVER RIDGE PT
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-1528
Country	:	US
Telephone Number	:	501-231-1012
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 RIVER RIDGE PT
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-1528
Country	:	US
Telephone Number	:	501-231-1012
Fax Number	:

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

Provider Enumeration Date	:	01/19/2009
Last Update Date	:	01/19/2009

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Directions to “ MARY JO MORRISON SLP” Practice Location

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