Provider Demographics
NPI:1043869886
Name:TITUS, JOCELYN B (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:B
Last Name:TITUS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-807 KIME ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1292
Mailing Address - Country:US
Mailing Address - Phone:605-660-7437
Mailing Address - Fax:
Practice Address - Street 1:1031 ROSS AVE
Practice Address - Street 2:
Practice Address - City:DUPONT
Practice Address - State:WA
Practice Address - Zip Code:98327-9754
Practice Address - Country:US
Practice Address - Phone:605-660-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-04
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA235Z00000X
HI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist