Provider Demographics
NPI:1790207942
Name:KNAZIK PHELPS, JOCELYN CARRIE (MS, CGC)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:CARRIE
Last Name:KNAZIK PHELPS
Suffix:
Gender:F
Credentials:MS, CGC
Other - Prefix:
Other - First Name:JOCELYN
Other - Middle Name:CARRIE
Other - Last Name:KNAZIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8901 ROCKVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Practice Address - Street 2:8901 ROCKVILLE PIKE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5991
Practice Address - Country:US
Practice Address - Phone:301-295-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
17621OtherAMERICAN BOARD OF GENETIC COUNSELING (ABGC)