Provider Demographics
NPI:1336435064
Name:MORGAN, MARIANNE (MCD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MCD
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:613 CASTLE BROOK DR
Mailing Address - Street 2:
Mailing Address - City:PRATTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36066-5632
Mailing Address - Country:US
Mailing Address - Phone:334-750-8793
Mailing Address - Fax:844-965-9437
Practice Address - Street 1:613 CASTLE BROOK DR
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5632
Practice Address - Country:US
Practice Address - Phone:334-750-8793
Practice Address - Fax:844-965-9437
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007824235Z00000X
AL3730235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist