Provider Demographics
NPI:1790196012
Name:LAMEIRE, JOYCE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:LAMEIRE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 154
Mailing Address - Street 2:
Mailing Address - City:AZTEC
Mailing Address - State:NM
Mailing Address - Zip Code:87410-0154
Mailing Address - Country:US
Mailing Address - Phone:505-330-5256
Mailing Address - Fax:
Practice Address - Street 1:2800 HUTTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-4560
Practice Address - Country:US
Practice Address - Phone:505-564-9002
Practice Address - Fax:505-564-9022
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3529235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist