| NPI | 1124878285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANGELA PULIDO-BANNER Owner/Psychologist 775-553-0668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR1300X Clinic/Center Rural Health | |
| Enumeration Date | 2024-03-22 |
| Last Update Date | 2024-03-22 |