Provider Demographics
NPI:1104388669
Name:GORMAN, JOY (BA)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:GORMAN
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:POIRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:270 HOOKAHI ST STE 207
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1466
Mailing Address - Country:US
Mailing Address - Phone:808-250-8806
Mailing Address - Fax:808-242-6650
Practice Address - Street 1:270 HOOKAHI ST STE 207
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1466
Practice Address - Country:US
Practice Address - Phone:808-250-8806
Practice Address - Fax:808-242-6650
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor