Provider Demographics
NPI:1447739206
Name:SMITH, JOY MICHELLE (MS)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:MICHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:JOY
Other - Middle Name:MICHELLE
Other - Last Name:FIELDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:1420 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:FL
Mailing Address - Zip Code:34769-4748
Mailing Address - Country:US
Mailing Address - Phone:470-262-5339
Mailing Address - Fax:
Practice Address - Street 1:2479 ALOMA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:407-657-6692
Practice Address - Fax:407-894-6010
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2018-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist