Provider Demographics
NPI:1962013557
Name:OWENS, MORGAN (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:OWENS
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 1:350 THE VLG UNIT 302
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2636
Mailing Address - Country:US
Mailing Address - Phone:609-658-1223
Mailing Address - Fax:
Practice Address - Street 1:350 THE VLG UNIT 302
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2636
Practice Address - Country:US
Practice Address - Phone:609-658-1223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28576235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty