Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 32002557A | IN |
NPI | 1023653458 |
---|---|
Provider Name | Megan Danielle Morris |
First Address | Mishawaka, IN 46544-2641 |
Second Address | Mishawaka, IN 46544-2641 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2019 |
Last Update Date | 08/11/2019 |