Healthcare Provider Details

I. General information

NPI: 1851941884
Provider Name (Legal Business Name): JOSHUA SLY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2019
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 N 2350 W
FARR WEST UT
84404-5177
US

IV. Provider business mailing address

1989 N 2530 W
CLINTON UT
84015-8488
US

V. Phone/Fax

Practice location:
  • Phone: 801-452-1940
  • Fax:
Mailing address:
  • Phone: 702-302-8241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA0925
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: