Provider Demographics
NPI:1508168626
Name:MORGAN, BETH ALLISON (CCC-SLP, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ALLISON
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CCC-SLP, IBCLC
Other - Prefix:MS
Other - First Name:BETH
Other - Middle Name:ALLISON
Other - Last Name:JONES-MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SLP, IBCLC
Mailing Address - Street 1:6630 COLLEYVILLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-6272
Mailing Address - Country:US
Mailing Address - Phone:682-429-4411
Mailing Address - Fax:817-421-1280
Practice Address - Street 1:6630 COLLEYVILLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-6272
Practice Address - Country:US
Practice Address - Phone:682-429-4411
Practice Address - Fax:817-421-1280
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105261235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist