Provider Demographics
NPI:1225449242
Name:KOEPPER, MORGAN K (PSYD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:K
Last Name:KOEPPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:K
Other - Last Name:PANORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:4362 NORTHLAKE BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-6270
Mailing Address - Country:US
Mailing Address - Phone:615-724-7829
Mailing Address - Fax:
Practice Address - Street 1:4362 NORTHLAKE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6270
Practice Address - Country:US
Practice Address - Phone:561-724-7829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9020103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist