Provider Demographics
NPI:1083225213
Name:MORRISON, EMILY GRACE (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:GRACE
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-5151
Mailing Address - Country:US
Mailing Address - Phone:318-354-6808
Mailing Address - Fax:
Practice Address - Street 1:5604 COLISEUM BLVD STE A
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3993
Practice Address - Country:US
Practice Address - Phone:318-487-5282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA766133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered