Provider Demographics
NPI:1245515550
Name:MORROW, LEONA LYNNE
Entity type:Individual
Prefix:
First Name:LEONA
Middle Name:LYNNE
Last Name:MORROW
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LEONA
Other - Middle Name:STEWART
Other - Last Name:CARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MT, MMP
Mailing Address - Street 1:7 DUNWOODY PARK
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6711
Mailing Address - Country:US
Mailing Address - Phone:706-429-6529
Mailing Address - Fax:
Practice Address - Street 1:7 DUNWOODY PARK
Practice Address - Street 2:SUITE 103
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6711
Practice Address - Country:US
Practice Address - Phone:706-429-6529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-18
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT001643225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAMT001643OtherMASSAGE THERAPIST