Provider Demographics
NPI:1316981723
Name:HAHN, MORGAN RAE (MS CCC/A)
Entity type:Individual
Prefix:MRS
First Name:MORGAN
Middle Name:RAE
Last Name:HAHN
Suffix:
Gender:F
Credentials:MS CCC/A
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:RAE
Other - Last Name:SHOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC/A
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:525 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6967
Practice Address - Country:US
Practice Address - Phone:573-882-7903
Practice Address - Fax:573-884-4607
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004018273231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO338374101Medicaid
MO338374101Medicaid
MO217291826Medicare ID - Type Unspecified