Provider Demographics
NPI:1578674321
Name:MORRIS, VICKI THERESE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:THERESE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22508 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-2154
Mailing Address - Country:US
Mailing Address - Phone:708-743-1081
Mailing Address - Fax:708-747-0466
Practice Address - Street 1:22508 RIDGEWAY AVE
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-2154
Practice Address - Country:US
Practice Address - Phone:708-743-1081
Practice Address - Fax:708-747-0466
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist