Provider Demographics
NPI:1538706007
Name:JOANN MASSEY PSY D
Entity Type:Organization
Organization Name:JOANN MASSEY PSY D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:850-384-1801
Mailing Address - Street 1:1221 E DE SOTO ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-3337
Mailing Address - Country:US
Mailing Address - Phone:850-439-2100
Mailing Address - Fax:850-439-2122
Practice Address - Street 1:1221 E DE SOTO ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-3337
Practice Address - Country:US
Practice Address - Phone:850-439-2100
Practice Address - Fax:850-439-2122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-04
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Single Specialty