MEDICARE: MORGAN DANIELLE BRUCE ED.S., NCSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1699490904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MORGAN DANIELLE BRUCE ED.S., NCSP

Provider Business Mailing Address
First Line	:	3746 82ND AVENUE CIR E APT 102
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-6329
Country	:	US
Telephone Number	:	434-258-7646
Fax Number	:

Provider Business Practice Location Address
First Line	:	3746 82ND AVENUE CIR E APT 102
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34243-6329
Country	:	US
Telephone Number	:	434-258-7646
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2022
Last Update Date	:	10/10/2022

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