Provider Demographics
NPI:1174984496
Name:GRIFFIN, MORGAN TAYLER (COTA/L)
Entity type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:TAYLER
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ESOR CIR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-3696
Mailing Address - Country:US
Mailing Address - Phone:270-543-6665
Mailing Address - Fax:
Practice Address - Street 1:255 ESOR CIR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:KY
Practice Address - Zip Code:42345-3696
Practice Address - Country:US
Practice Address - Phone:270-543-6665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-14
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYBOTOTA00225084224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant