Provider Demographics
NPI:1912349648
Name:MORSE, KELLY A (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:MORSE
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HARROUN RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2168
Mailing Address - Country:US
Mailing Address - Phone:419-824-5595
Mailing Address - Fax:419-824-1743
Practice Address - Street 1:5300 HARROUN RD STE 100
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2182
Practice Address - Country:US
Practice Address - Phone:419-824-5595
Practice Address - Fax:419-824-1743
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH000061170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS