Provider Demographics
NPI:1568160166
Name:JOICE, MELISSA LOUISE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LOUISE
Last Name:JOICE
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 1:4235 CASCADE RD SE#3
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546
Mailing Address - Country:US
Mailing Address - Phone:877-654-4144
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE PLEASANT RD S
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MI
Practice Address - Zip Code:49266-9541
Practice Address - Country:US
Practice Address - Phone:517-825-0916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician