MEDICARE: MARISSA MORRIS

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1710046677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA MORRIS

Provider Business Mailing Address
First Line	:	277 GA 74 306
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-7612
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	277 GA 74 306
Second Line	:
City	:	PEACHTREE CITY
State	:	GA
Zip	:	30269-7612
Country	:	US
Telephone Number	:	678-383-1210
Fax Number	:

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

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	02/24/2017

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Directions to “ MARISSA MORRIS ” Practice Location

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