Basic Information
| Provider Information | |||||||||
| NPI: | 1912399031 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MORRIS | ||||||||
| FirstName: | BLANCA | ||||||||
| MiddleName: | FLOR | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.S. CCC - SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MARTINEZ | ||||||||
| OtherFirstName: | BLANCA | ||||||||
| OtherMiddleName: | FLOR | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | M.S. CCC - SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 245 CAHABA VALLEY PARKWAY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059426820 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2218 W. 32ND ST. | ||||||||
| Address2: | |||||||||
| City: | JOPLIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4176235264 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 2015042965 | MO | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | OK | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.