Provider Demographics
NPI:1093475139
Name:KNISLEY, MORGAN (OT)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:KNISLEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:523 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:IL
Mailing Address - Zip Code:61920-4122
Mailing Address - Country:US
Mailing Address - Phone:217-621-7950
Mailing Address - Fax:
Practice Address - Street 1:523 COOLIDGE AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:IL
Practice Address - Zip Code:61920-4122
Practice Address - Country:US
Practice Address - Phone:217-621-7950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty