Provider Demographics
NPI:1699490904
Name:BRUCE, MORGAN DANIELLE (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:DANIELLE
Last Name:BRUCE
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3746 82ND AVENUE CIR E APT 102
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-6329
Mailing Address - Country:US
Mailing Address - Phone:434-258-7646
Mailing Address - Fax:
Practice Address - Street 1:3746 82ND AVENUE CIR E APT 102
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-6329
Practice Address - Country:US
Practice Address - Phone:434-258-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool