Provider Demographics
NPI:1598036493
Name:DWIRE, JOSHUA D (PSYD)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:D
Last Name:DWIRE
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JOSHUA
Other - Middle Name:D
Other - Last Name:DWIRE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:5546 CAMINO AL NORTE STE 2-298
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-0805
Mailing Address - Country:US
Mailing Address - Phone:702-831-0788
Mailing Address - Fax:702-463-9087
Practice Address - Street 1:720 W CHEYENNE AVE STE 50
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89030-7844
Practice Address - Country:US
Practice Address - Phone:702-831-0788
Practice Address - Fax:702-463-9087
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-24
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1287103TC0700X
NVPY0737103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty