Provider Demographics
NPI:1871190702
Name:JOSIPOVIC, VANJA (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:VANJA
Middle Name:
Last Name:JOSIPOVIC
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8693 BLAKELY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1465
Mailing Address - Country:US
Mailing Address - Phone:702-994-8008
Mailing Address - Fax:
Practice Address - Street 1:366 E MESA VERDE LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1812
Practice Address - Country:US
Practice Address - Phone:702-227-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-04
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVOT-2540225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist