Provider Demographics
NPI:1134257561
Name:MORGAN, SHANNON S (MCD,CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:S
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MCD,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 CHOPIN DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8507
Mailing Address - Country:US
Mailing Address - Phone:225-248-0620
Mailing Address - Fax:
Practice Address - Street 1:8676 GOODWOOD BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-7914
Practice Address - Country:US
Practice Address - Phone:225-923-1140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4823235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist