Basic Information
| Provider Information | |||||||||
| NPI: | 1174966725 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MORGAN | ||||||||
| FirstName: | BRITTANY | ||||||||
| MiddleName: | DALLAS | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 127 HAYWOOD DR | ||||||||
| Address2: | |||||||||
| City: | RAEFORD | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283765314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622318050 | ||||||||
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| Practice Location | |||||||||
| Address1: | 960 COMMONWEALTH BLVD | ||||||||
| Address2: | |||||||||
| City: | TUPELO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 388049762 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6622603789 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2013 | ||||||||
| LastUpdateDate: | 02/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 10052 | NC | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | S4191 | MS | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.