MEDICARE: MELISSA LOUISE JOICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1568160166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LOUISE JOICE

Provider Business Mailing Address
First Line	:	4235 CASCADE RD SE#3
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546
Country	:	US
Telephone Number	:	877-654-4144
Fax Number	:

Provider Business Practice Location Address
First Line	:	5700 LAKE PLEASANT RD S
Second Line	:
City	:	OSSEO
State	:	MI
Zip	:	49266-9541
Country	:	US
Telephone Number	:	517-825-0916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2023
Last Update Date	:	02/22/2023

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Directions to “ MELISSA LOUISE JOICE ” Practice Location

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