Provider Demographics
NPI:1598439150
Name:MORROW, CARLA G
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:G
Last Name:MORROW
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 1:4150 COTTAGE PATH
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-9372
Mailing Address - Country:US
Mailing Address - Phone:269-313-9613
Mailing Address - Fax:
Practice Address - Street 1:1030 MINERS RD STE C
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-9709
Practice Address - Country:US
Practice Address - Phone:269-235-9083
Practice Address - Fax:888-243-8250
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-05
Last Update Date:2023-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000846235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist