Healthcare Provider Details

I. General information

NPI: 1326441221
Provider Name (Legal Business Name): JUSTINE MARIE MOKESKI SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JUSTINE MARIE FILIPOVICH

II. Dates (important events)

Enumeration Date: 10/06/2014
Last Update Date: 01/15/2020
Certification Date: 01/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 W SUNSET RD
HENDERSON NV
89014-6681
US

IV. Provider business mailing address

1159 CASTLE POINT AVE
HENDERSON NV
89074-8837
US

V. Phone/Fax

Practice location:
  • Phone: 702-515-4009
  • Fax:
Mailing address:
  • Phone: 702-245-7889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: