Provider Demographics
NPI:1912869397
Name:BENEDICT, JOYCE ANN (MT)
Entity type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:ANN
Last Name:BENEDICT
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 N BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:ROMEO
Mailing Address - State:MI
Mailing Address - Zip Code:48065-4768
Mailing Address - Country:US
Mailing Address - Phone:586-299-1201
Mailing Address - Fax:
Practice Address - Street 1:216 N BAILEY ST
Practice Address - Street 2:
Practice Address - City:ROMEO
Practice Address - State:MI
Practice Address - Zip Code:48065-4768
Practice Address - Country:US
Practice Address - Phone:586-299-1201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501007691225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty