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 1:11211 PROSPERITY FARMS RD
Mailing Address - Street 2:SUITE C303
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-3446
Mailing Address - Country:US
Mailing Address - Phone:561-688-9795
Mailing Address - Fax:561-688-9796
Practice Address - Street 1:11211 PROSPERITY FARMS RD
Practice Address - Street 2:SUITE C303
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-3446
Practice Address - Country:US
Practice Address - Phone:561-688-9795
Practice Address - Fax:561-688-9796
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY 9020103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist