Provider Demographics
NPI:1154814200
Name:MORRIS, MADISON CLAIRE (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:CLAIRE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 14TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1340
Mailing Address - Country:US
Mailing Address - Phone:918-519-3610
Mailing Address - Fax:
Practice Address - Street 1:1616 14TH ST APT 1A
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-1340
Practice Address - Country:US
Practice Address - Phone:918-519-3610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0005409225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist