Healthcare Provider Details

I. General information

NPI: 1477473668
Provider Name (Legal Business Name): MORGAN GRACE PRINCE MA CF- SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416 NORTH HAUGH AVE.
PICAYUNE MS
39466-4011
US

IV. Provider business mailing address

6205 HIGHWAY 43 N
CARRIERE MS
39426-8660
US

V. Phone/Fax

Practice location:
  • Phone: 769-356-8931
  • Fax: 601-620-4117
Mailing address:
  • Phone: 769-356-8931
  • Fax: 601-620-4117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberS-5522
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: