Provider Demographics
NPI:1760867691
Name:MILLER, MORGAN MCKENZI (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:MCKENZI
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7501 E MCDOWELL RD
Mailing Address - Street 2:APT 1052
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3534
Mailing Address - Country:US
Mailing Address - Phone:419-966-1593
Mailing Address - Fax:
Practice Address - Street 1:17100 E SHEA BLVD
Practice Address - Street 2:SUITE 225
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-6625
Practice Address - Country:US
Practice Address - Phone:480-837-4565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP9515235Z00000X
AZSLP9515235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist