Provider Demographics
NPI:1760611271
Name:MORRISSEY, DEBRA J
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:J
Last Name:MORRISSEY
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 1:1622 N 50TH PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53208-2205
Mailing Address - Country:US
Mailing Address - Phone:414-355-3060
Mailing Address - Fax:414-355-3547
Practice Address - Street 1:5600 W BROWN DEER RD
Practice Address - Street 2:SUITE 4
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-2311
Practice Address - Country:US
Practice Address - Phone:414-355-3060
Practice Address - Fax:414-355-3547
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI748-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI748-154OtherLICENSE NUMBER