Provider Demographics
NPI:1891822409
Name:LAWLER, JOYCE MARIE (LICENSED PSYCHOLOGIS)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:MARIE
Last Name:LAWLER
Suffix:
Gender:F
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 3RD AVENUE SE
Mailing Address - Street 2:IRONWOOD SQUARE SUITE 201
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904
Mailing Address - Country:US
Mailing Address - Phone:507-289-5992
Mailing Address - Fax:507-529-3669
Practice Address - Street 1:300 3RD AVENUE SE
Practice Address - Street 2:IRONWOOD SQUARE SUITE 201
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904
Practice Address - Country:US
Practice Address - Phone:507-289-5992
Practice Address - Fax:507-529-3669
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP3812103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN16472OtherMAYO PROVIDER
MN30Q10LAOtherBCBS INDIVIDUAL
MN654326000Medicaid
MN125478OtherUCARE
MN30Q09LAOtherBCBS GROUP