Provider Demographics
NPI:1538586227
Name:MORRIS, LAURA LA NELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LA NELLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LA NELLE
Other - Last Name:ISEMINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:23515 BEAVER CRK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-7333
Mailing Address - Country:US
Mailing Address - Phone:210-410-0615
Mailing Address - Fax:
Practice Address - Street 1:23515 BEAVER CRK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7333
Practice Address - Country:US
Practice Address - Phone:210-410-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102805235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist