Provider Demographics
NPI:1063933034
Name:MORRISSEY, BRANDY (MA, CF SLP)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:MA, CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MARLBORO DR
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-1226
Mailing Address - Country:US
Mailing Address - Phone:740-466-4408
Mailing Address - Fax:
Practice Address - Street 1:475 WESTERN AVE STE E
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-2288
Practice Address - Country:US
Practice Address - Phone:740-702-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.2017160SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist