Provider Demographics
NPI:1861848319
Name:MARRIE, JOYCE
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:MARRIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4050 OLSON MEMORIAL HWY STE 195
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5345
Mailing Address - Country:US
Mailing Address - Phone:763-522-0100
Mailing Address - Fax:
Practice Address - Street 1:4050 OLSON MEMORIAL HWY STE 195
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422
Practice Address - Country:US
Practice Address - Phone:763-522-0100
Practice Address - Fax:763-588-0100
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24056104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker