Provider Demographics
NPI:1760769665
Name:JOY L. TERRELL, PH.D. LLC
Entity Type:Organization
Organization Name:JOY L. TERRELL, PH.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:225-678-6269
Mailing Address - Street 1:8221 SUMMA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-3451
Mailing Address - Country:US
Mailing Address - Phone:225-678-6269
Mailing Address - Fax:225-454-6916
Practice Address - Street 1:8221 SUMMA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3451
Practice Address - Country:US
Practice Address - Phone:225-678-6269
Practice Address - Fax:225-454-6916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1129251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health