Provider Demographics
NPI:1730894395
Name:WARREN, MORGAN CHEYENNE (MS CF-SLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:CHEYENNE
Last Name:WARREN
Suffix:
Gender:F
Credentials:MS CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DAVIS LN
Mailing Address - Street 2:
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-7008
Mailing Address - Country:US
Mailing Address - Phone:985-351-9040
Mailing Address - Fax:
Practice Address - Street 1:59656 PULESTON RD
Practice Address - Street 2:
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422-5616
Practice Address - Country:US
Practice Address - Phone:985-748-7153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8517235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA12082020Medicaid