Provider Demographics
NPI:1568793446
Name:MORGAN, TWYLA DENISE
Entity Type:Individual
Prefix:
First Name:TWYLA
Middle Name:DENISE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TWYLA
Other - Middle Name:DENISE
Other - Last Name:MORGAN-MONTAGUE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:442 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-3402
Mailing Address - Country:US
Mailing Address - Phone:267-663-9339
Mailing Address - Fax:
Practice Address - Street 1:442 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:LOWER GWYNEDD
Practice Address - State:PA
Practice Address - Zip Code:19002-3402
Practice Address - Country:US
Practice Address - Phone:267-663-9339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-17
Last Update Date:2010-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst