Provider Demographics
NPI:1053611624
Name:MORGAN, LEE ANNE (SLP/CCC/MS)
Entity type:Individual
Prefix:
First Name:LEE ANNE
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:SLP/CCC/MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 ANTLER TRL
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-6530
Mailing Address - Country:US
Mailing Address - Phone:601-750-4700
Mailing Address - Fax:
Practice Address - Street 1:5271 GETWELL RD
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-9608
Practice Address - Country:US
Practice Address - Phone:662-772-5924
Practice Address - Fax:662-772-5925
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3371235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist