Provider Demographics
NPI:1629298674
Name:MORLAS, JACQUELINE
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:
Last Name:MORLAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3462 RUSSELL PL
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1714
Mailing Address - Country:US
Mailing Address - Phone:917-238-9913
Mailing Address - Fax:
Practice Address - Street 1:3462 RUSSELL PL
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-1714
Practice Address - Country:US
Practice Address - Phone:917-238-9913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health