Provider Demographics
NPI:1992044952
Name:MORRELL, RENEE Y (CERTIFIED TEACHER)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:Y
Last Name:MORRELL
Suffix:
Gender:F
Credentials:CERTIFIED TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10553-2108
Mailing Address - Country:US
Mailing Address - Phone:718-705-2262
Mailing Address - Fax:
Practice Address - Street 1:427 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10553-2108
Practice Address - Country:US
Practice Address - Phone:718-705-2262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2013-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162144021174400000X
NY615649051174400000X
NY999590001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist