Provider Demographics
NPI:1598057101
Name:WILSON-MORISE, LA'SHONE RENEE (OT)
Entity Type:Individual
Prefix:MRS
First Name:LA'SHONE
Middle Name:RENEE
Last Name:WILSON-MORISE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2977 PRAIRIE BLF
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-1857
Mailing Address - Country:US
Mailing Address - Phone:210-215-1840
Mailing Address - Fax:
Practice Address - Street 1:2977 PRAIRIE BLF
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-1857
Practice Address - Country:US
Practice Address - Phone:210-215-1840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL14629225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology