Provider Demographics
NPI:1417775149
Name:BLISS, MORGAN (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:BLISS
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 1:362 FRONT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:MA
Mailing Address - Zip Code:02738-1591
Mailing Address - Country:US
Mailing Address - Phone:508-728-4154
Mailing Address - Fax:
Practice Address - Street 1:120 WEST CENTER STREET SUITE 3
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379
Practice Address - Country:US
Practice Address - Phone:508-230-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP100875235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist