Provider Demographics
NPI:1760290084
Name:KIDD, MORGAN ALEXIS (MS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:ALEXIS
Last Name:KIDD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13535 SW 50TH CT
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-5936
Mailing Address - Country:US
Mailing Address - Phone:954-821-1580
Mailing Address - Fax:
Practice Address - Street 1:13535 SW 50TH CT
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-5936
Practice Address - Country:US
Practice Address - Phone:754-280-2442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3976969171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach