| NPI | 1013671049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BLACKSTONE Practice Manager 775-562-4509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103G00000X Clinical Neuropsychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0200X Psychologist Forensic | |
| 103TH0100X Psychologist Health Service | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 235Z00000X Speech-Language Pathologist | |
| 363LF0000X Nurse Practitioner Family | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2021-10-26 |