Provider Demographics
NPI:1023348794
Name:CLEVELAND, JOY
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:CLEVELAND
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 1:29 WOODLAND RD
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1239
Mailing Address - Country:US
Mailing Address - Phone:973-761-7116
Mailing Address - Fax:
Practice Address - Street 1:100 MONROE ST
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-5002
Practice Address - Country:US
Practice Address - Phone:908-595-6618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-01
Last Update Date:2010-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-1775235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist