Healthcare Provider Details

I. General information

NPI: 1700308160
Provider Name (Legal Business Name): MORGAN RAE KAMOROFF M.S.,CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2017
Last Update Date: 07/05/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17100 E SHEA BLVD STE 600
FOUNTAIN HILLS AZ
85268-6663
US

IV. Provider business mailing address

6817 SOUTHPOINT PKWY STE 1602
JACKSONVILLE FL
32216-6298
US

V. Phone/Fax

Practice location:
  • Phone: 480-837-4565
  • Fax:
Mailing address:
  • Phone: 904-945-7556
  • Fax: 904-379-0113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA17633
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: