Provider Demographics
NPI:1578240602
Name:LEWALLEN, MORGAN NICOLE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:NICOLE
Last Name:LEWALLEN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 AVENUE H # A
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-6219
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 SOUTH STREET
Practice Address - Street 2:SUITE 500
Practice Address - City:VIDOR
Practice Address - State:TX
Practice Address - Zip Code:77662
Practice Address - Country:US
Practice Address - Phone:409-498-4066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist