Provider Demographics
NPI:1215616883
Name:MORGAN, KIRSTEN NICOLE (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:NICOLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4805 HILLSIDE CT
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-3893
Mailing Address - Country:US
Mailing Address - Phone:678-602-8440
Mailing Address - Fax:
Practice Address - Street 1:2655 DALLAS HIGHWAY SW
Practice Address - Street 2:UNIT 320
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064
Practice Address - Country:US
Practice Address - Phone:770-428-2112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist