Provider Demographics
NPI:1063922698
Name:JOYNER, FELISHA (LMBT)
Entity type:Individual
Prefix:
First Name:FELISHA
Middle Name:
Last Name:JOYNER
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 PATRICK HENRY DR NW APT F
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-7898
Mailing Address - Country:US
Mailing Address - Phone:980-318-4901
Mailing Address - Fax:
Practice Address - Street 1:3135 PATRICK HENRY DR NW APT F
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-7898
Practice Address - Country:US
Practice Address - Phone:980-318-4901
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16791225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist