Provider Demographics
NPI:1952876229
Name:MORRISON, LAURA HALES (RD, LD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:HALES
Last Name:MORRISON
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:AMANDA
Other - Last Name:MORRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAURA AMANDA HALES
Mailing Address - Street 1:631 BESSEMER SUPER HWY
Mailing Address - Street 2:
Mailing Address - City:MIDFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35228-3013
Mailing Address - Country:US
Mailing Address - Phone:205-241-5250
Mailing Address - Fax:205-241-5235
Practice Address - Street 1:631 BESSEMER SUPER HWY
Practice Address - Street 2:
Practice Address - City:MIDFIELD
Practice Address - State:AL
Practice Address - Zip Code:35228-3013
Practice Address - Country:US
Practice Address - Phone:205-241-5250
Practice Address - Fax:205-241-5235
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1649133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered