Provider Demographics
NPI:1104114404
Name:LIPTON, MORGAN
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:LIPTON
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 1:4320 MONROE DR
Mailing Address - Street 2:APT. D
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-6969
Mailing Address - Country:US
Mailing Address - Phone:303-249-9417
Mailing Address - Fax:
Practice Address - Street 1:4320 MONROE DR
Practice Address - Street 2:APT. D
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-6969
Practice Address - Country:US
Practice Address - Phone:303-249-9417
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12128665235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist