Provider Demographics
NPI:1780256370
Name:KIZER, MORGAN ELIZABETH (MSCCCSLP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ELIZABETH
Last Name:KIZER
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:ELIZABETH
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 N ALLEGHANEY AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4408
Mailing Address - Country:US
Mailing Address - Phone:432-332-8244
Mailing Address - Fax:432-580-7428
Practice Address - Street 1:620 N ALLEGHANEY AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4408
Practice Address - Country:US
Practice Address - Phone:432-332-8244
Practice Address - Fax:432-580-7428
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117230235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117230OtherSPEECH LICENSE