Provider Demographics
NPI:1770269219
Name:BLAIR, MORGAN LAYNE (MS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:LAYNE
Last Name:BLAIR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:LAYNE
Other - Last Name:HILLEBRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40431 OLD PIKE RD
Mailing Address - Street 2:
Mailing Address - City:HOWE
Mailing Address - State:OK
Mailing Address - Zip Code:74940-7385
Mailing Address - Country:US
Mailing Address - Phone:918-721-3198
Mailing Address - Fax:
Practice Address - Street 1:2300 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-2009
Practice Address - Country:US
Practice Address - Phone:918-962-0198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist