Provider Demographics
NPI:1851160279
Name:BLAND, JOY (MA)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:BLAND
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GOBBLER DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MO
Mailing Address - Zip Code:63379-2578
Mailing Address - Country:US
Mailing Address - Phone:636-345-1106
Mailing Address - Fax:636-356-1319
Practice Address - Street 1:8759 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7538
Practice Address - Country:US
Practice Address - Phone:636-345-1106
Practice Address - Fax:636-356-1319
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021018627101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty