Provider Demographics
NPI:1912124744
Name:MORGAN, KATHLEEN I (MS CCC S P)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:I
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS CCC S P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-6824
Mailing Address - Country:US
Mailing Address - Phone:918-712-8500
Mailing Address - Fax:918-741-3630
Practice Address - Street 1:1612 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-6824
Practice Address - Country:US
Practice Address - Phone:918-712-8500
Practice Address - Fax:918-741-3630
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK198235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist