Provider Demographics
NPI:1346768629
Name:JOSEPH, DRUE ARYN
Entity Type:Individual
Prefix:
First Name:DRUE
Middle Name:ARYN
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DRUE
Other - Middle Name:ARYN
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4934 HIGHLAND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-1142
Mailing Address - Country:US
Mailing Address - Phone:248-599-9669
Mailing Address - Fax:
Practice Address - Street 1:4934 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-1142
Practice Address - Country:US
Practice Address - Phone:248-599-9669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst