Provider Demographics
NPI:1841579372
Name:BRUTON, JOYCE GLENN (MS)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:GLENN
Last Name:BRUTON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 ASPENRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-7666
Mailing Address - Country:US
Mailing Address - Phone:407-905-5044
Mailing Address - Fax:
Practice Address - Street 1:5104 N ORANGE BLOSSOM TRL
Practice Address - Street 2:SUITE 224
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-1042
Practice Address - Country:US
Practice Address - Phone:407-905-5044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health