Provider Demographics
NPI:1265910624
Name:STANLEY, MORGAN DULL (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:DULL
Last Name:STANLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 TOWN PARK DR
Mailing Address - Street 2:
Mailing Address - City:ADVANCE
Mailing Address - State:NC
Mailing Address - Zip Code:27006-8605
Mailing Address - Country:US
Mailing Address - Phone:336-391-7217
Mailing Address - Fax:
Practice Address - Street 1:7449 FAIR OAKS DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9849
Practice Address - Country:US
Practice Address - Phone:336-747-1153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-29
Last Update Date:2018-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist