Provider Demographics
NPI:1982812806
Name:MORRIS, EMILY GRACE (COTA)
Entity type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:GRACE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:GRACE
Other - Last Name:WIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:523 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BOLIVAR
Mailing Address - State:NY
Mailing Address - Zip Code:14715-1110
Mailing Address - Country:US
Mailing Address - Phone:585-928-9902
Mailing Address - Fax:
Practice Address - Street 1:515 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1513
Practice Address - Country:US
Practice Address - Phone:716-375-7481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005882-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant