Provider Demographics
NPI:1326319765
Name:RENAUD, JOYCE RITA (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:RITA
Last Name:RENAUD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 DIXIE BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-2217
Mailing Address - Country:US
Mailing Address - Phone:573-979-1865
Mailing Address - Fax:573-651-2155
Practice Address - Street 1:1843 DIXIE BLVD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-2217
Practice Address - Country:US
Practice Address - Phone:573-979-1865
Practice Address - Fax:573-651-2155
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-17
Last Update Date:2012-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01704235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist