Provider Demographics
NPI:1780020693
Name:MORGAN, CICELY
Entity Type:Individual
Prefix:MS
First Name:CICELY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 E DESERT INN RD
Mailing Address - Street 2:APT 704
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109-9382
Mailing Address - Country:US
Mailing Address - Phone:702-378-6688
Mailing Address - Fax:
Practice Address - Street 1:850 E DESERT INN RD
Practice Address - Street 2:APT 704
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89109-9382
Practice Address - Country:US
Practice Address - Phone:702-378-6688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner