Provider Demographics
NPI:1003327057
Name:MORSE, LINDA ANN
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANN
Last Name:MORSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8237 SEVEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LAKE SPIVEY
Mailing Address - State:GA
Mailing Address - Zip Code:30236-4098
Mailing Address - Country:US
Mailing Address - Phone:678-372-1179
Mailing Address - Fax:
Practice Address - Street 1:8237 SEVEN OAKS DR
Practice Address - Street 2:
Practice Address - City:LAKE SPIVEY
Practice Address - State:GA
Practice Address - Zip Code:30236-4098
Practice Address - Country:US
Practice Address - Phone:678-372-1179
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-17
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency