Provider Demographics
NPI:1831319532
Name:MORRIS, TERRY (SLP)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11818 ROBINDALE RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40243-1369
Mailing Address - Country:US
Mailing Address - Phone:502-244-0687
Mailing Address - Fax:
Practice Address - Street 1:2520 BARDSTOWN RD
Practice Address - Street 2:SUITE 8
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-2685
Practice Address - Country:US
Practice Address - Phone:502-451-2142
Practice Address - Fax:502-451-2740
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1014235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1463OtherCBIS PROVIDER NUMBER