Provider Demographics
NPI:1366580334
Name:TEAS, JOYCE MARIE (INTERVENTION SPECIAL)
Entity type:Individual
Prefix:MRS
First Name:JOYCE
Middle Name:MARIE
Last Name:TEAS
Suffix:
Gender:F
Credentials:INTERVENTION SPECIAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 BLAKEY RD
Mailing Address - Street 2:
Mailing Address - City:HEBER SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72543-7854
Mailing Address - Country:US
Mailing Address - Phone:501-206-0490
Mailing Address - Fax:501-589-2065
Practice Address - Street 1:212 ROSEBUD RD
Practice Address - Street 2:
Practice Address - City:QUITMAN
Practice Address - State:AR
Practice Address - Zip Code:72131-9265
Practice Address - Country:US
Practice Address - Phone:501-589-2065
Practice Address - Fax:501-589-2065
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator