Provider Demographics
NPI:1245014364
Name:GREASER, MORGAN PAIGE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:PAIGE
Last Name:GREASER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 FOREST DR
Mailing Address - Street 2:
Mailing Address - City:RIDGELEY
Mailing Address - State:WV
Mailing Address - Zip Code:26753-7451
Mailing Address - Country:US
Mailing Address - Phone:301-268-8034
Mailing Address - Fax:
Practice Address - Street 1:36 BAKER PL
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2826
Practice Address - Country:US
Practice Address - Phone:304-788-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-2421235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist