Provider Demographics
NPI:1811178544
Name:MORGAN STEVENSON, JOAN DANIELLE (SP)
Entity type:Individual
Prefix:MS
First Name:JOAN
Middle Name:DANIELLE
Last Name:MORGAN STEVENSON
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3099
Mailing Address - Country:US
Mailing Address - Phone:978-287-7977
Mailing Address - Fax:978-287-7801
Practice Address - Street 1:1269 MAIN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3099
Practice Address - Country:US
Practice Address - Phone:978-287-7977
Practice Address - Fax:978-287-7801
Is Sole Proprietor?:No
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3204-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist