Provider Demographics
NPI:1821578402
Name:BECKMON, MORGAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BECKMON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 CALLOWAY RD APT 912
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75707-1558
Mailing Address - Country:US
Mailing Address - Phone:817-863-8481
Mailing Address - Fax:
Practice Address - Street 1:2801 CALLOWAY RD APT 912
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-1558
Practice Address - Country:US
Practice Address - Phone:817-863-8481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist