Provider Demographics
NPI:1598015026
Name:JOHNSTON, MORGAN WATSON
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:WATSON
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 LEAMON BAKER RD
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220
Mailing Address - Country:US
Mailing Address - Phone:318-537-1784
Mailing Address - Fax:
Practice Address - Street 1:5960 LEAMON BAKER RD
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-6815
Practice Address - Country:US
Practice Address - Phone:318-537-1784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-12
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist