Provider Demographics
NPI:1467266395
Name:JOSEPH, ILIANA TRISH
Entity type:Individual
Prefix:
First Name:ILIANA
Middle Name:TRISH
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ILIANA
Other - Middle Name:TRISH
Other - Last Name:JORCILUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 TAFT AVE SE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32909-5119
Mailing Address - Country:US
Mailing Address - Phone:561-706-4088
Mailing Address - Fax:
Practice Address - Street 1:950 TAFT AVE SE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32909-5119
Practice Address - Country:US
Practice Address - Phone:561-706-4088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst