MEDICARE: MR. MARTY ASHLEY JOYNER M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	AZ4201	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598808198
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARTY ASHLEY JOYNER M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	12411 W RANCHO DR
Second Line	:
City	:	LITCHFIELD PARK
State	:	AZ
Zip	:	85340-3493
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 W ROANOKE AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85009-1304
Country	:	US
Telephone Number	:	602-442-2419
Fax Number	:

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

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	07/08/2007

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