Provider Demographics
NPI:1922005867
Name:PERRY, JOYCE GAY (BRAGG) (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:GAY (BRAGG)
Last Name:PERRY
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:PO BOX 327
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:WV
Mailing Address - Zip Code:25621-0327
Mailing Address - Country:US
Mailing Address - Phone:304-664-6414
Mailing Address - Fax:
Practice Address - Street 1:689 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1315
Practice Address - Country:US
Practice Address - Phone:304-733-3331
Practice Address - Fax:304-733-3334
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1728101Y00000X
WVAP00940567104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker