Provider Demographics
NPI:1770568941
Name:WYMER, JOY H (PHD)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:H
Last Name:WYMER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 BELLE HALL PKWY UNIT 202
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8322
Mailing Address - Country:US
Mailing Address - Phone:843-412-0927
Mailing Address - Fax:843-225-2323
Practice Address - Street 1:501 BELLE HALL PKWY UNIT 202
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8322
Practice Address - Country:US
Practice Address - Phone:843-412-0927
Practice Address - Fax:843-225-2323
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-10
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC986103G00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPS0414Medicaid
SCQ340388396Medicare ID - Type Unspecified