Provider Demographics
NPI:1427300532
Name:PEMBERTON, JOY R (PHD)
Entity type:Individual
Prefix:DR
First Name:JOY
Middle Name:R
Last Name:PEMBERTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4301 W. MARKHAM, #554
Mailing Address - Street 2:PSYCHIATRIC RESEARCH INSTITUTE, UAMS
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4301 W. MARKHAM, #554
Practice Address - Street 2:PSYCHIATRIC RESEARCH INSTITUTE, UAMS
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-526-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR12-03AP-PL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical