Provider Demographics
NPI:1033495395
Name:MORGAN, KATHLEEN LANCE (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LANCE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:MISS
Other - First Name:KATHLEEN
Other - Middle Name:MARIA
Other - Last Name:LANCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:
Mailing Address - City:MAGGIE VALLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28751-0549
Mailing Address - Country:US
Mailing Address - Phone:828-646-3014
Mailing Address - Fax:828-566-3005
Practice Address - Street 1:75 FISHER LOOP
Practice Address - Street 2:
Practice Address - City:MAGGIE VALLEY
Practice Address - State:NC
Practice Address - Zip Code:28751-5531
Practice Address - Country:US
Practice Address - Phone:828-566-3014
Practice Address - Fax:828-566-3005
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-31
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist