Basic Information
Provider Information
NPI: 1831799162
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRIS
FirstName: SOULEIKA
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Mailing Information
Address1: 25117 SW PARKWAY AVE STE D
Address2:  
City: WILSONVILLE
State: OR
PostalCode: 970709697
CountryCode: US
TelephoneNumber:  
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Practice Location
Address1: 499 ALT KEENE RD
Address2:  
City: LARGO
State: FL
PostalCode: 337711652
CountryCode: US
TelephoneNumber: 7275864211
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2020
LastUpdateDate: 10/27/2020
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
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IsSoleProprietor: N
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NPICertificationDate: 10/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X  Y Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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