Provider Demographics
NPI:1083043103
Name:MORRISON, KERRY (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12028 N EXETER WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7837
Mailing Address - Country:US
Mailing Address - Phone:919-413-6643
Mailing Address - Fax:
Practice Address - Street 1:3015 RED GRAPE DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-4865
Practice Address - Country:US
Practice Address - Phone:919-610-9298
Practice Address - Fax:919-439-6380
Is Sole Proprietor?:No
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist