Provider Demographics
NPI:1144675836
Name:CLARK-FLOOD, JOYCE DANIELLE I (MSN-ED, RN-BC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:DANIELLE
Last Name:CLARK-FLOOD
Suffix:I
Gender:F
Credentials:MSN-ED, RN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5644 NORTHINGTON CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1350
Mailing Address - Country:US
Mailing Address - Phone:248-973-8625
Mailing Address - Fax:
Practice Address - Street 1:1410 S TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0046
Practice Address - Country:US
Practice Address - Phone:248-451-3741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-30
Last Update Date:2016-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704152171163WH0200X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No163WH0200XNursing Service ProvidersRegistered NurseHome Health