Provider Demographics
NPI:1790242790
Name:MORGAN, KELLI LEEANN (MS CF-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KELLI
Middle Name:LEEANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 APPLE ST
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38506-5293
Mailing Address - Country:US
Mailing Address - Phone:931-261-7946
Mailing Address - Fax:
Practice Address - Street 1:419 E BROAD ST
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3339
Practice Address - Country:US
Practice Address - Phone:931-854-5056
Practice Address - Fax:931-854-0074
Is Sole Proprietor?:No
Enumeration Date:2019-02-26
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4780235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist