Provider Demographics
NPI:1760994636
Name:MORGAN, RITA L (MS, MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:L
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS, MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 UNDERHILL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-2668
Mailing Address - Country:US
Mailing Address - Phone:845-364-9622
Mailing Address - Fax:845-694-8692
Practice Address - Street 1:37 UNDERHILL DR STE 100
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-2668
Practice Address - Country:US
Practice Address - Phone:845-364-9622
Practice Address - Fax:845-694-8692
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009522235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty