Individual
JOYCE WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
153 CANDLE CT, ENGLEWOOD, OH 45322-2741
(937) 430-0739
Mailing address
153 CANDLE CT, ENGLEWOOD, OH 45322-2741
(937) 430-0739
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2615
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP.2615
STATE LICENSE
OH
Enumeration date
04/26/2016
Last updated
04/26/2016
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