Provider Demographics
NPI:1609979251
Name:MORRILL, AIMEE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:MORRILL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S SUBURBAN DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3762
Mailing Address - Country:US
Mailing Address - Phone:605-373-0727
Mailing Address - Fax:
Practice Address - Street 1:315 N WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:VIBORG
Practice Address - State:SD
Practice Address - Zip Code:57070-0368
Practice Address - Country:US
Practice Address - Phone:605-326-5161
Practice Address - Fax:605-326-5196
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01556235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
09100451OtherAMERICAN SPEECH ASSOC
SD5832172Medicaid