Provider Demographics
NPI:1659524551
Name:MCMORRIS, ALETHEA DAWN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALETHEA
Middle Name:DAWN
Last Name:MCMORRIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MRS
Other - First Name:ALETHEA
Other - Middle Name:DAWN
Other - Last Name:MICHIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:65 DARREN RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12540-6233
Mailing Address - Country:US
Mailing Address - Phone:845-592-0997
Mailing Address - Fax:
Practice Address - Street 1:65 DARREN RD
Practice Address - Street 2:
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-6233
Practice Address - Country:US
Practice Address - Phone:845-592-0997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014488235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist