Provider Demographics
NPI:1932940749
Name:MORGAN, TYLER LENAE
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:LENAE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 CLINIC RD
Mailing Address - Street 2:
Mailing Address - City:TATE
Mailing Address - State:GA
Mailing Address - Zip Code:30177-2506
Mailing Address - Country:US
Mailing Address - Phone:678-459-5991
Mailing Address - Fax:
Practice Address - Street 1:89 CLINIC RD
Practice Address - Street 2:
Practice Address - City:TATE
Practice Address - State:GA
Practice Address - Zip Code:30177-2506
Practice Address - Country:US
Practice Address - Phone:678-459-5991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001130237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist