Provider Demographics
NPI:1780290510
Name:WEST, JOSHUA
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:WEST
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 1:951 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:01827-1118
Mailing Address - Country:US
Mailing Address - Phone:978-877-7085
Mailing Address - Fax:
Practice Address - Street 1:3 EXECUTIVE PARK DR STE 279
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-7067
Practice Address - Country:US
Practice Address - Phone:888-754-0398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-17
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician