Provider Demographics
NPI:1992141519
Name:ELDEIRY, JOY (MA)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:
Last Name:ELDEIRY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E CALIFORNIA BLVD APT 312
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-3655
Mailing Address - Country:US
Mailing Address - Phone:847-809-6508
Mailing Address - Fax:
Practice Address - Street 1:350 E CALIFORNIA BLVD APT 312
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-3655
Practice Address - Country:US
Practice Address - Phone:847-809-6508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist