Provider Demographics
NPI:1376335091
Name:PANKEY, MORGAN TAYLOR
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:TAYLOR
Last Name:PANKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 CULPEO DR
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-9929
Mailing Address - Country:US
Mailing Address - Phone:530-788-5180
Mailing Address - Fax:
Practice Address - Street 1:845 GREEN GARDEN WAY
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6757
Practice Address - Country:US
Practice Address - Phone:843-999-3654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician