Provider Demographics
NPI:1396065264
Name:MORREL, TANYA M (PHD)
Entity type:Individual
Prefix:DR
First Name:TANYA
Middle Name:M
Last Name:MORREL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:410-323-8750
Mailing Address - Fax:
Practice Address - Street 1:222 BOSLEY AVE
Practice Address - Street 2:SUITE A5
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4328
Practice Address - Country:US
Practice Address - Phone:410-832-0113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03705103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist