Provider Demographics
NPI:1164759270
Name:WILKES, JOY S (MA/CCC-S)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:S
Last Name:WILKES
Suffix:
Gender:F
Credentials:MA/CCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-0790
Mailing Address - Country:US
Mailing Address - Phone:606-329-8558
Mailing Address - Fax:606-329-8195
Practice Address - Street 1:3701 LANDSDOWNE DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:KY
Practice Address - Zip Code:41102-5422
Practice Address - Country:US
Practice Address - Phone:606-324-3005
Practice Address - Fax:606-329-8195
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY165351235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist