MEDICARE: MR. JOSHUA A PLOSKER LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LMSW-12604	AZ

General Provider Information

NPI Number	:	1518104801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA A PLOSKER LMSW

Provider Business Mailing Address
First Line	:	1811 S ALMA SCHOOL RD
Second Line	:	STE 160
City	:	MESA
State	:	AZ
Zip	:	85210-3001
Country	:	US
Telephone Number	:	480-831-7566
Fax Number	:	480-962-7671

Provider Business Practice Location Address
First Line	:	8825 N 23RD AVE
Second Line	:	STE 100
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4147
Country	:	US
Telephone Number	:	602-861-2255
Fax Number	:	602-861-2288

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2009
Last Update Date	:	01/08/2009

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