Provider Demographics
NPI:1457549347
Name:SEVERANCE, JOYCE LYNN (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:LYNN
Last Name:SEVERANCE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4251 FOUR OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-3654
Mailing Address - Country:US
Mailing Address - Phone:352-246-5384
Mailing Address - Fax:866-731-1397
Practice Address - Street 1:4251 FOUR OAKS BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-3654
Practice Address - Country:US
Practice Address - Phone:352-246-5384
Practice Address - Fax:866-731-1397
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT 9439225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics