Provider Demographics
NPI:1548404270
Name:MARKOWICZ, JOCELYN A (PHD)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:A
Last Name:MARKOWICZ
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:843 PENNIMAN AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1757
Mailing Address - Country:US
Mailing Address - Phone:734-335-7709
Mailing Address - Fax:734-335-7711
Practice Address - Street 1:843 PENNIMAN AVE
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1757
Practice Address - Country:US
Practice Address - Phone:734-335-7709
Practice Address - Fax:734-335-7711
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23802103T00000X
MI6301015407103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist