Provider Demographics
NPI:1417352956
Name:MORRIS, MICHELLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 BRENTWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:COPLEY
Mailing Address - State:OH
Mailing Address - Zip Code:44321-1486
Mailing Address - Country:US
Mailing Address - Phone:330-668-2021
Mailing Address - Fax:
Practice Address - Street 1:12000 NAVARRE RD SW
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:OH
Practice Address - Zip Code:44662-9486
Practice Address - Country:US
Practice Address - Phone:330-767-3913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.5634235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist