Provider Demographics
NPI:1730504804
Name:AMISSAH, JOYCE
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:
Last Name:AMISSAH
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 1:577 SHEWSBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-2415
Mailing Address - Country:US
Mailing Address - Phone:702-782-4246
Mailing Address - Fax:
Practice Address - Street 1:577 SHEWSBURY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89178-2415
Practice Address - Country:US
Practice Address - Phone:702-782-4246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health