Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 2583 | OH |
NPI | 1003953258 |
---|---|
Provider Name | Dr. Misty Leanne Morris |
First Address | Painesville, OH 44077-1707 |
Second Address | Painesville, OH 44077-1707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |