Provider Demographics
NPI:1346362050
Name:TINDALL, JOY LUTZ (EDD)
Entity Type:Individual
Prefix:DR
First Name:JOY
Middle Name:LUTZ
Last Name:TINDALL
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1174
Mailing Address - Country:US
Mailing Address - Phone:908-788-9001
Mailing Address - Fax:908-788-9044
Practice Address - Street 1:84 PARK AVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1174
Practice Address - Country:US
Practice Address - Phone:908-788-9001
Practice Address - Fax:908-788-9044
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSIO2055103TB0200X, 103TC0700X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily