Provider Demographics
NPI:1235115742
Name:BURNS-HOLLAND, JOYCE A (LSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:A
Last Name:BURNS-HOLLAND
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:A
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1519 TIMBER CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-3650
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1441 FORUM DR
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-2508
Practice Address - Country:US
Practice Address - Phone:573-364-7551
Practice Address - Fax:573-364-4898
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO002720104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker