Healthcare Provider Details

I. General information

NPI: 1649142332
Provider Name (Legal Business Name): MORGAN KRUEGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2014 LINCOLNWAY E STE 3
GOSHEN IN
46526-6818
US

IV. Provider business mailing address

2014 LINCOLNWAY E STE 3
GOSHEN IN
46526-6818
US

V. Phone/Fax

Practice location:
  • Phone: 239-920-3948
  • Fax: 888-751-4019
Mailing address:
  • Phone: 239-920-3948
  • Fax: 888-751-3748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-471476
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: