Provider Demographics
NPI:1336293182
Name:MORGAN, SANDRA GAIL (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:GAIL
Last Name:MORGAN
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 1:113 DUBLIN DR SE
Mailing Address - Street 2:
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-4462
Mailing Address - Country:US
Mailing Address - Phone:706-625-3264
Mailing Address - Fax:706-625-0175
Practice Address - Street 1:113 DUBLIN DR SE
Practice Address - Street 2:
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-4462
Practice Address - Country:US
Practice Address - Phone:706-625-3264
Practice Address - Fax:706-625-0175
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000996235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist