Provider Demographics
NPI:1336931617
Name:SULLENS, MORGAN BAILEY (ATC)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:BAILEY
Last Name:SULLENS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2252 N 44TH ST APT 2165
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85008-7222
Mailing Address - Country:US
Mailing Address - Phone:951-403-4969
Mailing Address - Fax:
Practice Address - Street 1:3033 N 44TH ST STE 360
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7276
Practice Address - Country:US
Practice Address - Phone:602-648-5444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer