Provider Demographics
NPI:1538456835
Name:MORGAN, REBECCA ASBILLE (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ASBILLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:D
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:2129 PORTWOOD WAY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-6634
Mailing Address - Country:US
Mailing Address - Phone:817-988-5879
Mailing Address - Fax:844-917-2767
Practice Address - Street 1:2129 PORTWOOD WAY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-6634
Practice Address - Country:US
Practice Address - Phone:817-988-5879
Practice Address - Fax:844-917-2767
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX399192Medicare UPIN