Provider Demographics
NPI:1235359795
Name:MORRILL, ANDREW A
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:A
Last Name:MORRILL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469B LAFAYETTE CTR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3943
Mailing Address - Country:US
Mailing Address - Phone:636-386-0200
Mailing Address - Fax:636-386-0210
Practice Address - Street 1:469B LAFAYETTE CTR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-3943
Practice Address - Country:US
Practice Address - Phone:636-386-0200
Practice Address - Fax:636-386-0210
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007004131237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist