Provider Demographics
NPI:1053847012
Name:HAINES, MORGAN (MA)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HAINES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 S PEARL ST
Mailing Address - Street 2:APT. 101
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4235
Mailing Address - Country:US
Mailing Address - Phone:419-296-7853
Mailing Address - Fax:
Practice Address - Street 1:909 S PEARL ST
Practice Address - Street 2:APT. 101
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80209-4235
Practice Address - Country:US
Practice Address - Phone:419-296-7853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSLP.0000149235Z00000X
CA29569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist