Provider Demographics
NPI:1386486058
Name:MORRIS, SARA NIKOLE (SLP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:NIKOLE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 BOWENS MILL RD SW
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-3926
Mailing Address - Country:US
Mailing Address - Phone:912-331-0846
Mailing Address - Fax:912-331-0847
Practice Address - Street 1:618 BOWENS MILL RD SW
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-3926
Practice Address - Country:US
Practice Address - Phone:912-331-0846
Practice Address - Fax:912-331-0847
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP011505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist