Provider Demographics
NPI:1922551001
Name:VANDERFORD, MORGAN HAYNES (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:HAYNES
Last Name:VANDERFORD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:MORGAN
Other - Middle Name:DEANNE
Other - Last Name:HAYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:2076 HERZOG
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-6433
Mailing Address - Country:US
Mailing Address - Phone:361-960-8833
Mailing Address - Fax:
Practice Address - Street 1:2076 HERZOG
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6433
Practice Address - Country:US
Practice Address - Phone:361-906-8833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist