Provider Demographics
NPI:1053885566
Name:MORRIS, BEVERLY A
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-3514
Mailing Address - Country:US
Mailing Address - Phone:410-677-5814
Mailing Address - Fax:410-677-5882
Practice Address - Street 1:711 LAKE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-3514
Practice Address - Country:US
Practice Address - Phone:410-677-5814
Practice Address - Fax:410-677-5882
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool