Provider Demographics
NPI:1598908147
Name:WILLIAMS, JOYCE WALEAN
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:WALEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:WALEAN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:709 E POYTHRESS ST
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:VA
Mailing Address - Zip Code:23860-3108
Mailing Address - Country:US
Mailing Address - Phone:804-541-3759
Mailing Address - Fax:804-458-3530
Practice Address - Street 1:709 E POYTHRESS ST
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:VA
Practice Address - Zip Code:23860-3108
Practice Address - Country:US
Practice Address - Phone:804-541-3759
Practice Address - Fax:804-458-3530
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-13
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA13168171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator