Provider Demographics
NPI:1154685832
Name:MORRIS, SHAUNA (MS ED)
Entity Type:Individual
Prefix:MS
First Name:SHAUNA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 W 57TH ST
Mailing Address - Street 2:APT 2E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3030
Mailing Address - Country:US
Mailing Address - Phone:732-547-4605
Mailing Address - Fax:
Practice Address - Street 1:452 W 57TH ST
Practice Address - Street 2:APT 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3030
Practice Address - Country:US
Practice Address - Phone:732-547-4605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-27
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY537992111174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist