Provider Demographics
NPI:1083310437
Name:MORRING, WILLITA LEANDA
Entity Type:Individual
Prefix:
First Name:WILLITA
Middle Name:LEANDA
Last Name:MORRING
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 1:77 DAWN LN
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-5558
Mailing Address - Country:US
Mailing Address - Phone:757-287-4325
Mailing Address - Fax:
Practice Address - Street 1:77 DAWN LN
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-5558
Practice Address - Country:US
Practice Address - Phone:757-287-4325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019000988225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist