Provider Demographics
NPI:1750593455
Name:MORRIS, PATRICE (SLP)
Entity type:Individual
Prefix:
First Name:PATRICE
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 1:3865 COLONIAL TRL SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-7614
Mailing Address - Country:US
Mailing Address - Phone:678-691-3532
Mailing Address - Fax:678-691-3532
Practice Address - Street 1:3865 COLONAIL TRAIL
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-7614
Practice Address - Country:US
Practice Address - Phone:678-691-3532
Practice Address - Fax:678-691-3532
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006551235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist