Provider Demographics
NPI:1568594968
Name:MORGAN, JENNIFER BETH (MA,CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BETH
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MA,CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10181 FOXWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3358
Mailing Address - Country:US
Mailing Address - Phone:440-582-8728
Mailing Address - Fax:
Practice Address - Street 1:10181 FOXWOOD DR
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3358
Practice Address - Country:US
Practice Address - Phone:440-582-8728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000371696OtherANTHEM BC BS