Provider Demographics
NPI:1518332303
Name:MORRIS, MACY ELAYNA
Entity Type:Individual
Prefix:
First Name:MACY
Middle Name:ELAYNA
Last Name:MORRIS
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 1:11A QUEEN ELIZABETH CT
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21619-2546
Mailing Address - Country:US
Mailing Address - Phone:443-521-9507
Mailing Address - Fax:
Practice Address - Street 1:11A QUEEN ELIZABETH CT
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:MD
Practice Address - Zip Code:21619-2546
Practice Address - Country:US
Practice Address - Phone:443-521-9507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-06
Last Update Date:2017-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer