Provider Demographics
NPI:1023648151
Name:MORGAN, TISHA WOODS
Entity type:Individual
Prefix:
First Name:TISHA
Middle Name:WOODS
Last Name:MORGAN
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 1:102 MICAH WAY STE 1103
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769-4161
Mailing Address - Country:US
Mailing Address - Phone:256-259-0333
Mailing Address - Fax:
Practice Address - Street 1:102 MICAH WAY STE 1103
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769-4161
Practice Address - Country:US
Practice Address - Phone:256-259-0333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4167237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist