Provider Demographics
NPI:1265912158
Name:MACY, JOI LAVONNE (CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:JOI
Middle Name:LAVONNE
Last Name:MACY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2612 CEDARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4381
Mailing Address - Country:US
Mailing Address - Phone:817-729-9671
Mailing Address - Fax:
Practice Address - Street 1:2612 CEDARWOOD CT
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4381
Practice Address - Country:US
Practice Address - Phone:817-729-9671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16576235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist