Provider Demographics
NPI:1477600237
Name:LOYD, DEIDRA JOEL (MSW)
Entity Type:Individual
Prefix:MS
First Name:DEIDRA
Middle Name:JOEL
Last Name:LOYD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4737 N LONGWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46226-2827
Mailing Address - Country:US
Mailing Address - Phone:317-513-9404
Mailing Address - Fax:
Practice Address - Street 1:3925 N COLLEGE AVE STE 101
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46205-2734
Practice Address - Country:US
Practice Address - Phone:317-931-8018
Practice Address - Fax:317-931-0943
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker