Provider Demographics
NPI:1053913046
Name:MORELOCK, JANET MARIE SCHULTZ
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MARIE SCHULTZ
Last Name:MORELOCK
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 1:75 CONTINENTAL LN
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1430
Mailing Address - Country:US
Mailing Address - Phone:716-868-2653
Mailing Address - Fax:
Practice Address - Street 1:75 CONTINENTAL LN
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NY
Practice Address - Zip Code:14072-1430
Practice Address - Country:US
Practice Address - Phone:716-868-2653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-13
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005374-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist