Provider Demographics
NPI:1386948081
Name:MORRISON, TINA L (CI/CT, NAD V, SC:L)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:F
Credentials:CI/CT, NAD V, SC:L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:OLD ORCHARD BEACH
Mailing Address - State:ME
Mailing Address - Zip Code:04064-2234
Mailing Address - Country:US
Mailing Address - Phone:207-838-8462
Mailing Address - Fax:
Practice Address - Street 1:41 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:OLD ORCHARD BEACH
Practice Address - State:ME
Practice Address - Zip Code:04064-2234
Practice Address - Country:US
Practice Address - Phone:207-838-8462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MECIT 48OtherSTATE OF MAINE OFFICE OF LICENSE AND REGULATION
MENOT YET GIVENOtherNON TRADITIONAL COMMUNICATION SPECIALIST