Doctor Name: | MS. LYNETTE ELLEN MORRIS |
NPI Number: | 1295005007 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD,CDE |
License Number: | |
Business Practice Address: | 4369 Baldwin Rd Metamora, MI - 484558976 |
Business Phone Number: | 5862010869 |
Business Fax Number: | |
Mailing Address: | 4369 Baldwin Rd, METAMORA |
State: | MI |
Postal Code: | 484558976 |
Phone Number: | 5862010869 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2012 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133VN1004X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | Nutrition, Pediatric |
Taxonomy Definition: |