Provider Demographics
NPI:1184330599
Name:MIKHAIL, JOY MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:MARIE
Last Name:MIKHAIL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:867 BOYLSTON STREET 5TH FLOOR
Mailing Address - Street 2:#1539
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2774
Mailing Address - Country:US
Mailing Address - Phone:508-203-1565
Mailing Address - Fax:
Practice Address - Street 1:867 BOYLSTON STREET 5TH FLOOR
Practice Address - Street 2:#1539
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:508-203-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP77334235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist