Provider Demographics
NPI:1285941476
Name:TANYA M MORREL PHD LLC
Entity type:Organization
Organization Name:TANYA M MORREL PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TANYA
Authorized Official - Middle Name:MORAN
Authorized Official - Last Name:MORREL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:410-832-0113
Mailing Address - Street 1:5301 FALLS ROAD TER
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1905
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 BOSLEY AVE
Practice Address - Street 2:SUITE A5
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-4328
Practice Address - Country:US
Practice Address - Phone:410-832-0113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03705261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)