Provider Demographics
NPI:1013678671
Name:WILSON-ROBERTS, JOYCE D
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:D
Last Name:WILSON-ROBERTS
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 1:8460 LIMEKILN PIKE APT 234
Mailing Address - Street 2:
Mailing Address - City:WYNCOTE
Mailing Address - State:PA
Mailing Address - Zip Code:19095-2656
Mailing Address - Country:US
Mailing Address - Phone:267-626-3110
Mailing Address - Fax:
Practice Address - Street 1:8460 LIMEKILN PIKE APT 234
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-2656
Practice Address - Country:US
Practice Address - Phone:267-626-3110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PA22534695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health