Provider Demographics
NPI:1245876572
Name:PROCHNOW, MORGAN PAIGE
Entity type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:PAIGE
Last Name:PROCHNOW
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 1:1502 N 113TH PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5892
Mailing Address - Country:US
Mailing Address - Phone:402-440-0948
Mailing Address - Fax:
Practice Address - Street 1:UNDERWOOD HILLS EARLY LEARNING CENTER
Practice Address - Street 2:9030 WESTERN AVENUE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2265
Practice Address - Country:US
Practice Address - Phone:402-440-0948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE742235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist