Provider Demographics
NPI:1619271400
Name:MEADOWS, MORGAN K (MACCC-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:K
Last Name:MEADOWS
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 992184
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96099-2184
Mailing Address - Country:US
Mailing Address - Phone:530-276-1599
Mailing Address - Fax:
Practice Address - Street 1:3733 FAIROAKS CT
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2249
Practice Address - Country:US
Practice Address - Phone:530-276-1599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP15434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist