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General NPI Number Information
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NPI Number | 1295542272
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Entity Type | Organization
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Legal Business Name | JOURNEY FORWARD AUTISM LLC
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Dates
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Enumeration Date | 12/13/2024
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 6800 W CHEYENNE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89108-4590
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Country | US
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Telephone | 702-482-8387
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Fax | 702-781-3252
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Provider Business Mailing Address
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Address Line | PO BOX 371855
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City | LAS VEGAS
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State | NV
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Zip | 89137-1855
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Country | US
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Telephone | 702-482-8387
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Fax | 702-781-3252
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE OLSEN
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Credential |
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Telephone | 702-596-4075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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