Healthcare Provider Details

I. General information

NPI: 1194646471
Provider Name (Legal Business Name): MORGAN LANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 E MCLELLAN RD
MESA AZ
85203-3840
US

IV. Provider business mailing address

1435 E MCLELLAN RD
MESA AZ
85203-3840
US

V. Phone/Fax

Practice location:
  • Phone: 480-472-7800
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP17549
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: