Provider Demographics
NPI:1790272342
Name:JOSCAK, AUBREY MICHELLE (BCBA)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:MICHELLE
Last Name:JOSCAK
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12697
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27709-2697
Mailing Address - Country:US
Mailing Address - Phone:919-371-2848
Mailing Address - Fax:919-467-6777
Practice Address - Street 1:PO BOX 12697
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27709-2697
Practice Address - Country:US
Practice Address - Phone:919-371-2848
Practice Address - Fax:919-467-6777
Is Sole Proprietor?:No
Enumeration Date:2018-04-19
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-22-60453103K00000X
NC525103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst