Provider Demographics
NPI:1184442261
Name:MORRELL, LAYLA
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:MORRELL
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 1:1961 CALUSA TRL
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:FL
Mailing Address - Zip Code:32068-8209
Mailing Address - Country:US
Mailing Address - Phone:904-314-4415
Mailing Address - Fax:
Practice Address - Street 1:1961 CALUSA TRL
Practice Address - Street 2:
Practice Address - City:MIDDLEBURG
Practice Address - State:FL
Practice Address - Zip Code:32068-8209
Practice Address - Country:US
Practice Address - Phone:904-314-4415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician