Provider Demographics
NPI:1356174437
Name:WORRELL, MORGAN GRACE
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:GRACE
Last Name:WORRELL
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 1:12865 S RANGELINE RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IN
Mailing Address - Zip Code:47842-7434
Mailing Address - Country:US
Mailing Address - Phone:217-264-4788
Mailing Address - Fax:
Practice Address - Street 1:15601 US HIGHWAY 150
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-6071
Practice Address - Country:US
Practice Address - Phone:217-465-5391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist