Provider Demographics
NPI:1649468927
Name:MORGAN, STACIE ANN (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:ANN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 TANNENBAUM CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9686
Mailing Address - Country:US
Mailing Address - Phone:336-207-7753
Mailing Address - Fax:
Practice Address - Street 1:4100 WELL SPRING DR
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8857
Practice Address - Country:US
Practice Address - Phone:336-545-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7155235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist