Provider Demographics
NPI:1356625743
Name:JOHNSON, JOYCE
Entity Type:Individual
Prefix:MS
First Name:JOYCE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 BONITA DESERT CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-3471
Mailing Address - Country:US
Mailing Address - Phone:702-326-8851
Mailing Address - Fax:
Practice Address - Street 1:3785 E SUNSET RD
Practice Address - Street 2:SUITE A-10
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-6259
Practice Address - Country:US
Practice Address - Phone:702-985-2345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-04
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst