Provider Demographics
NPI:1831801513
Name:ADAMS, MORGAN (OTRL)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5069 SHADYMEADOW LN APT C
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-8290
Mailing Address - Country:US
Mailing Address - Phone:815-514-1233
Mailing Address - Fax:
Practice Address - Street 1:8599 N 32ND ST STE 104
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MI
Practice Address - Zip Code:49083-8570
Practice Address - Country:US
Practice Address - Phone:269-397-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201012775225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist