Provider Demographics
NPI:1417791823
Name:LIVINGSTON, JOY (NBC-HWC)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:LIVINGSTON
Suffix:
Gender:
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 DALE ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55117-5603
Mailing Address - Country:US
Mailing Address - Phone:612-599-1098
Mailing Address - Fax:
Practice Address - Street 1:4053 SALEM DR W
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55129-9546
Practice Address - Country:US
Practice Address - Phone:612-599-1098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
A-3459812171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach