Provider Demographics
NPI:1164850731
Name:ROSSON, MORGAN
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:
Last Name:ROSSON
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 1:151 RIVER MIST CIR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:GA
Mailing Address - Zip Code:30549-8622
Mailing Address - Country:US
Mailing Address - Phone:706-410-5816
Mailing Address - Fax:
Practice Address - Street 1:151 RIVER MIST CIR
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:GA
Practice Address - Zip Code:30549-8622
Practice Address - Country:US
Practice Address - Phone:706-410-5816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist