Provider Demographics
NPI:1104027044
Name:MORRISON, WILLIAM GERARD (OTA)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GERARD
Last Name:MORRISON
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 N HORNE UNIT 50
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85203-3673
Mailing Address - Country:US
Mailing Address - Phone:480-610-1902
Mailing Address - Fax:
Practice Address - Street 1:16455 E AVENUE OF THE FOUNTAINS
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-8307
Practice Address - Country:US
Practice Address - Phone:480-836-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2886224Z00000X
NC6200224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant