Provider Demographics
NPI:1508283201
Name:MORRISON, HAYWOOD JUSTIN (MA SLP)
Entity Type:Individual
Prefix:MR
First Name:HAYWOOD
Middle Name:JUSTIN
Last Name:MORRISON
Suffix:
Gender:M
Credentials:MA SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SUNSET DR APT 333
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28147-7153
Mailing Address - Country:US
Mailing Address - Phone:704-273-0106
Mailing Address - Fax:
Practice Address - Street 1:210 SUNSET DR APT 333
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28147-7153
Practice Address - Country:US
Practice Address - Phone:704-273-0106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-20
Last Update Date:2014-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9571235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist