Provider Demographics
NPI:1154994523
Name:LANE, MORGAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:LANE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SPRING MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2947
Mailing Address - Country:US
Mailing Address - Phone:325-315-8985
Mailing Address - Fax:
Practice Address - Street 1:400 SPRING MEADOW CT
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2947
Practice Address - Country:US
Practice Address - Phone:325-315-8985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14037168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist