Provider Demographics
NPI:1336690254
Name:HOLWAY, JOY LYNN (RDN)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:LYNN
Last Name:HOLWAY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:JOY
Other - Middle Name:LYNN
Other - Last Name:POST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:113 LONG PINE DR
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:GA
Mailing Address - Zip Code:31763-3145
Mailing Address - Country:US
Mailing Address - Phone:239-682-0646
Mailing Address - Fax:
Practice Address - Street 1:113 LONG PINE DR
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:GA
Practice Address - Zip Code:31763-3145
Practice Address - Country:US
Practice Address - Phone:239-682-0646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD004675133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered