Provider Demographics
NPI:1629313267
Name:DEBERRY, JOYCE ANN
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:ANN
Last Name:DEBERRY
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 1:178 HIGHWAY 125
Mailing Address - Street 2:
Mailing Address - City:RAY CITY
Mailing Address - State:GA
Mailing Address - Zip Code:31645-7535
Mailing Address - Country:US
Mailing Address - Phone:478-334-9694
Mailing Address - Fax:
Practice Address - Street 1:178 HIGHWAY 125
Practice Address - Street 2:
Practice Address - City:RAY CITY
Practice Address - State:GA
Practice Address - Zip Code:31645-7535
Practice Address - Country:US
Practice Address - Phone:478-334-9694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-08
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker