Provider Demographics
NPI:1558642579
Name:MORGAN, COLLEEN IRELAND (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:IRELAND
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:COLLEEN
Other - Middle Name:MARY
Other - Last Name:IRELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8280 WILLOW OAKS CORPORATE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4518
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8280 WILLOW OAKS CORPORATE DR STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4518
Practice Address - Country:US
Practice Address - Phone:571-472-4300
Practice Address - Fax:571-665-6771
Is Sole Proprietor?:No
Enumeration Date:2011-09-03
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07811235Z00000X
DC000914235Z00000X
VA2202007907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist