Provider Demographics
NPI:1467784587
Name:YOXALL, JOYCE ELAINE (OT)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ELAINE
Last Name:YOXALL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 HIGHWAY 60
Mailing Address - Street 2:BOX 342
Mailing Address - City:SOCORRO
Mailing Address - State:NM
Mailing Address - Zip Code:87801-3919
Mailing Address - Country:US
Mailing Address - Phone:575-838-1100
Mailing Address - Fax:575-838-0394
Practice Address - Street 1:832 HIGHWAY 60
Practice Address - Street 2:BOX 342
Practice Address - City:SOCORRO
Practice Address - State:NM
Practice Address - Zip Code:87801-3919
Practice Address - Country:US
Practice Address - Phone:575-838-1100
Practice Address - Fax:575-838-0394
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-01
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM43827551Medicaid