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General NPI Number Information
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NPI Number | 1225851587
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Entity Type | Individual
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Provider Name | BETHANY MORGADO CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 690 MIAMI CIR NE STE 680
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City | ATLANTA
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State | GA
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Zip | 30324-3015
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Country | US
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Telephone | 770-302-6902
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Fax |
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Provider Business Mailing Address
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Address Line | 339 ANGIER AVE NE APT 1
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City | ATLANTA
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State | GA
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Zip | 30312-1005
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Country | US
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Telephone | 719-963-6849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 18.006777
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP012349
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License Number State | GA
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