Provider Demographics
NPI:1174842207
Name:BURRIS, JOY DIANE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:DIANE
Last Name:BURRIS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:DIANE
Other - Last Name:HANSFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6401 S US HIGHWAY 41
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4749
Mailing Address - Country:US
Mailing Address - Phone:812-299-1156
Mailing Address - Fax:812-298-3291
Practice Address - Street 1:6401 S US HIGHWAY 41
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802-4749
Practice Address - Country:US
Practice Address - Phone:812-299-1156
Practice Address - Fax:812-298-3291
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker