Provider Demographics
NPI:1124726708
Name:AVERY-WRIGHT, JOYCELYN CAMILLE
Entity type:Individual
Prefix:MS
First Name:JOYCELYN
Middle Name:CAMILLE
Last Name:AVERY-WRIGHT
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 1:3144 19TH AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-2905
Mailing Address - Country:US
Mailing Address - Phone:727-483-8678
Mailing Address - Fax:
Practice Address - Street 1:3144 19TH AVE S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-2905
Practice Address - Country:US
Practice Address - Phone:727-483-8678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator