Provider Demographics
NPI:1740034024
Name:STARRY, JOY LEE
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:LEE
Last Name:STARRY
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 1:4899 LOY RD
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:OH
Mailing Address - Zip Code:45326-9740
Mailing Address - Country:US
Mailing Address - Phone:937-214-4393
Mailing Address - Fax:
Practice Address - Street 1:4899 LOY RD
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OH
Practice Address - Zip Code:45326-9740
Practice Address - Country:US
Practice Address - Phone:937-214-4393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 347C00000X, 347E00000X
OH3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker