Provider Demographics
NPI:1700276672
Name:LAWRENCE, JOY JELINDA
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:JELINDA
Last Name:LAWRENCE
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 1:9584 COOLEY LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3940
Mailing Address - Country:US
Mailing Address - Phone:313-863-4645
Mailing Address - Fax:
Practice Address - Street 1:9584 COOLEY LAKE RD
Practice Address - Street 2:
Practice Address - City:WHITE LAKE
Practice Address - State:MI
Practice Address - Zip Code:48386-3940
Practice Address - Country:US
Practice Address - Phone:313-863-4645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other