Healthcare Provider Details

I. General information

NPI: 1336969740
Provider Name (Legal Business Name): MORGAN LYNN DYSON SLP-CF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2024
Last Update Date: 10/11/2024
Certification Date: 10/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2973 CRIPPLE CREEK TRL
GRAPEVINE TX
76051-4761
US

IV. Provider business mailing address

1431 GREENWAY DR STE 500
IRVING TX
75038-2444
US

V. Phone/Fax

Practice location:
  • Phone: 817-247-3829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number122403
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: