Provider Demographics
NPI:1063730315
Name:PAYNE-MORRIS, CARRIE JOYCE (MSCCC-SLP,MPH)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:JOYCE
Last Name:PAYNE-MORRIS
Suffix:
Gender:F
Credentials:MSCCC-SLP,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14553 S COUNTRY WOOD DR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-8716
Mailing Address - Country:US
Mailing Address - Phone:228-861-0584
Mailing Address - Fax:
Practice Address - Street 1:14553 S COUNTRY WOOD DR
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-8716
Practice Address - Country:US
Practice Address - Phone:228-861-0584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS1120235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist