Provider Demographics
NPI:1548080476
Name:MORRAL, SUSAN DEANN
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:DEANN
Last Name:MORRAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LEADSVILLE LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-1523
Mailing Address - Country:US
Mailing Address - Phone:304-704-2627
Mailing Address - Fax:
Practice Address - Street 1:98 LEADSVILLE LN
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-1523
Practice Address - Country:US
Practice Address - Phone:304-704-2627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency