Provider Demographics
NPI:1548786239
Name:SMITH, JOY L
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:L
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2673 MARINER AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-4205
Mailing Address - Country:US
Mailing Address - Phone:330-259-6031
Mailing Address - Fax:
Practice Address - Street 1:25 W RAYEN AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44503-1000
Practice Address - Country:US
Practice Address - Phone:330-746-6361
Practice Address - Fax:330-747-6360
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator