| Joyce Aultman Llc | |
|
1627 W 26th St Joplin MO 64804-0398 | |
| (417) 627-9601 | |
| (417) 627-9032 |
| Full Name | Joyce Aultman Llc |
|---|---|
| Speciality | Counselor |
| Location | 1627 W 26th St, Joplin, Missouri |
| Authorized Official Name and Position | Joyce Aultman (OWNER) |
| Authorized Official Contact | 4176279601 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Joyce Aultman Llc 1627 W 26th St Joplin MO 64804-0398 Ph: (417) 627-9601 | Joyce Aultman Llc 1627 W 26th St Joplin MO 64804-0398 Ph: (417) 627-9601 |
| NPI Number | 1811718661 |
|---|---|
| Provider Enumeration Date | 10/23/2024 |
| Last Update Date | 11/07/2024 |
| Certification Date | 11/07/2024 |
| Medicare PECOS PAC ID | 1557898301 |
|---|---|
| Medicare Enrollment ID | O20241218002483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811718661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Joyce L Aultman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740321249 PECOS PAC ID: 7810135159 Enrollment ID: I20231214003461 |
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