MEDICARE: MORGAN LEIGH GONZALES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	CF010	OK

General Provider Information

NPI Number	:	1700349230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN LEIGH GONZALES

Provider Business Mailing Address
First Line	:	302 N INDEPENDENCE ST STE 802
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73701-4046
Country	:	US
Telephone Number	:	580-334-1856
Fax Number	:	405-400-8795

Provider Business Practice Location Address
First Line	:	302 N INDEPENDENCE ST STE 802
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73701-4046
Country	:	US
Telephone Number	:	580-356-9976
Fax Number	:	405-400-8795

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2019
Last Update Date	:	03/03/2026

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Directions to “ MORGAN LEIGH GONZALES ” Practice Location

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