Provider Demographics
NPI:1629521661
Name:MORELL, JOCELYN (MA)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:MORELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:L1B CALLE BAMBOO DR
Mailing Address - Street 2:TORRIMAR ALTO
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00966-3143
Mailing Address - Country:US
Mailing Address - Phone:787-413-4429
Mailing Address - Fax:
Practice Address - Street 1:64 CALLE SANTA CRUZ
Practice Address - Street 2:SUITE 207
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-7003
Practice Address - Country:US
Practice Address - Phone:787-779-6243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2073103T00000X, 103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool