Provider Demographics
NPI:1609630573
Name:MENOLD, MORGAN (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:MENOLD
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 N CENTRAL EXPY APT 354
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-3251
Mailing Address - Country:US
Mailing Address - Phone:916-765-0744
Mailing Address - Fax:
Practice Address - Street 1:950 S I 35 E
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75146-3304
Practice Address - Country:US
Practice Address - Phone:972-274-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121988235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist