Provider Demographics
NPI:1659131951
Name:TRIBBLE, JOSHUA LAWRENCE
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:LAWRENCE
Last Name:TRIBBLE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 IVY SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-6074
Mailing Address - Country:US
Mailing Address - Phone:702-539-3757
Mailing Address - Fax:
Practice Address - Street 1:7061 W ARBY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89113-4452
Practice Address - Country:US
Practice Address - Phone:702-485-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-22-218197106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician