Provider Demographics
NPI:1194363317
Name:MORTON, DOROTHY (BA,MA,SP EDUCATION)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:BA,MA,SP EDUCATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 CEDARLAWN DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-5414
Mailing Address - Country:US
Mailing Address - Phone:504-975-3635
Mailing Address - Fax:
Practice Address - Street 1:2720 CEDARLAWN DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-5414
Practice Address - Country:US
Practice Address - Phone:504-975-3635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA05Medicaid