Provider Demographics
NPI:1629359062
Name:MORGENSTERN, PHYLLIS (MS, SLP)
Entity Type:Individual
Prefix:
First Name:PHYLLIS
Middle Name:
Last Name:MORGENSTERN
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 NW CORPORATE BLVD STE 110W
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8512
Mailing Address - Country:US
Mailing Address - Phone:561-289-3170
Mailing Address - Fax:
Practice Address - Street 1:1900 NW CORPORATE BLVD STE 110W
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8512
Practice Address - Country:US
Practice Address - Phone:561-289-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA12219235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist