Provider Demographics
NPI:1790323400
Name:BAKER, JOSHUA N (PHD, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:N
Last Name:BAKER
Suffix:
Gender:M
Credentials:PHD, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 CABANA BLANCA ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-5688
Mailing Address - Country:US
Mailing Address - Phone:702-353-7808
Mailing Address - Fax:
Practice Address - Street 1:56 CABANA BLANCA ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-5688
Practice Address - Country:US
Practice Address - Phone:702-353-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBA0271103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst