Provider Demographics
NPI:1962017392
Name:JOSKA, ALEXIS JOY
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JOY
Last Name:JOSKA
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 1:1060 WIGWAM PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8162
Mailing Address - Country:US
Mailing Address - Phone:702-847-6401
Mailing Address - Fax:
Practice Address - Street 1:1060 WIGWAM PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-8162
Practice Address - Country:US
Practice Address - Phone:702-847-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-20-134977106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician