1295009553 NPI number — MORGAN PAULSON SLP-A

Table of content: MORGAN PAULSON SLP-A (NPI 1295009553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295009553 NPI number — MORGAN PAULSON SLP-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAULSON
Provider First Name:
MORGAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
SLP-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295009553
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6821 E ALMERIA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCOTTSDALE
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85257-2607
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-650-9827
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17359 W SURPRISE FARMS LOOP N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SURPRISE
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85388-0283
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
623-523-8450
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2355S0801X , with the licence number:  #SLPA7399 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)