Provider Demographics
NPI:1356810048
Name:CRIBB, MORGAN KELLEY (OTR/L)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:KELLEY
Last Name:CRIBB
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 CYPRESS POINT CT
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27107-6069
Mailing Address - Country:US
Mailing Address - Phone:336-414-9940
Mailing Address - Fax:
Practice Address - Street 1:7700 US HIGHWAY 158
Practice Address - Street 2:
Practice Address - City:STOKESDALE
Practice Address - State:NC
Practice Address - Zip Code:27357-9346
Practice Address - Country:US
Practice Address - Phone:336-643-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12190225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist