Provider Demographics
NPI:1811185853
Name:JOYCE, MOLLY C (EDS)
Entity Type:Individual
Prefix:MISS
First Name:MOLLY
Middle Name:C
Last Name:JOYCE
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2995 N COLE RD
Mailing Address - Street 2:SUITE 255
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-5964
Mailing Address - Country:US
Mailing Address - Phone:208-376-0453
Mailing Address - Fax:208-376-0477
Practice Address - Street 1:2995 N COLE RD
Practice Address - Street 2:SUITE 255
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-5964
Practice Address - Country:US
Practice Address - Phone:208-376-0453
Practice Address - Fax:208-376-0477
Is Sole Proprietor?:No
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool