Provider Demographics
NPI:1689557662
Name:MCLEAN, JOCELYN (LMT)
Entity type:Individual
Prefix:MS
First Name:JOCELYN
Middle Name:
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6466 BEAVER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4196
Mailing Address - Country:US
Mailing Address - Phone:678-674-4414
Mailing Address - Fax:
Practice Address - Street 1:6466 BEAVER CREEK TRL
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-4196
Practice Address - Country:US
Practice Address - Phone:678-674-4414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT014937225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist