Provider Demographics
NPI:1982992277
Name:MORRIS, BETHANY ALYSA (CFY-SLP)
Entity Type:Individual
Prefix:MS
First Name:BETHANY
Middle Name:ALYSA
Last Name:MORRIS
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6306 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-1549
Mailing Address - Country:US
Mailing Address - Phone:602-279-5801
Mailing Address - Fax:602-279-0785
Practice Address - Street 1:6306 N 7TH ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-1549
Practice Address - Country:US
Practice Address - Phone:602-279-5801
Practice Address - Fax:602-279-0785
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP7317235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist