Provider Demographics
NPI:1780012229
Name:MORRIS, KATHLEEN (BS, MA)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 8TH ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE
Mailing Address - State:IL
Mailing Address - Zip Code:62558-9476
Mailing Address - Country:US
Mailing Address - Phone:217-737-9240
Mailing Address - Fax:
Practice Address - Street 1:501 8TH ST
Practice Address - Street 2:
Practice Address - City:PAWNEE
Practice Address - State:IL
Practice Address - Zip Code:62558-9476
Practice Address - Country:US
Practice Address - Phone:217-737-9240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-18
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist