Provider Demographics
NPI:1538535513
Name:JOYNER JAMES, KATHLEEN RENEE (OTD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RENEE
Last Name:JOYNER JAMES
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-6143
Mailing Address - Country:US
Mailing Address - Phone:660-341-3438
Mailing Address - Fax:660-785-1825
Practice Address - Street 1:60 OAK FOREST RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-5010
Practice Address - Country:US
Practice Address - Phone:843-815-2338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT006779225X00000X
MO2015025066225X00000X
SC4977225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist