Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 2305208405 | VA |
N | 2251G0304X | Physical Therapist - Geriatrics | 2305208405 | VA |
NPI | 1235703976 |
---|---|
Provider Name | Dr. Caroline Habliston Morris |
First Address | Alexandria, VA 22314-4763 |
Second Address | Alexandria, VA 22314-4763 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2021 |
Last Update Date | 17/05/2021 |