Provider Demographics
NPI:1841449618
Name:MORRIS, RANDY STEVEN (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MR
First Name:RANDY
Middle Name:STEVEN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
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Mailing Address - Street 1:6902 W 51ST ST
Mailing Address - Street 2:#213
Mailing Address - City:MISSION
Mailing Address - State:KS
Mailing Address - Zip Code:66202-1418
Mailing Address - Country:US
Mailing Address - Phone:913-671-7517
Mailing Address - Fax:
Practice Address - Street 1:2900 CHARLEVOIX DR SE
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7085
Practice Address - Country:US
Practice Address - Phone:800-634-1077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO02045235Z00000X
KS813235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist