Provider Demographics
NPI:1366790859
Name:HARRIS, JOY ANTONETTE
Entity type:Individual
Prefix:MS
First Name:JOY
Middle Name:ANTONETTE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TOINE
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1516 E TROPICANA AVE STE 137
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-6552
Mailing Address - Country:US
Mailing Address - Phone:702-530-2788
Mailing Address - Fax:
Practice Address - Street 1:1516 E TROPICANA AVE STE 137
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-6552
Practice Address - Country:US
Practice Address - Phone:702-530-2788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst