Provider Demographics
NPI:1093231094
Name:MORRIS, ANNELIESE MARGARET
Entity Type:Individual
Prefix:
First Name:ANNELIESE
Middle Name:MARGARET
Last Name:MORRIS
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 1:3 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2012
Mailing Address - Country:US
Mailing Address - Phone:631-553-1869
Mailing Address - Fax:
Practice Address - Street 1:586 W 177TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7214
Practice Address - Country:US
Practice Address - Phone:212-991-2630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist