Provider Demographics
NPI:1952923369
Name:MORRIS, MELANIE MARIE (LMBT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMBT
Mailing Address - Street 1:2106 GINNIE SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:KANNAPOLIS
Mailing Address - State:NC
Mailing Address - Zip Code:28081-6495
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9630 SHERRILL ESTATES RD STE B
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-6551
Practice Address - Country:US
Practice Address - Phone:704-223-0939
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16288225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty