Healthcare Provider Details

I. General information

NPI: 1427248749
Provider Name (Legal Business Name): TROY HELMUT SEIDL PH.D., M.ED.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 LOCUST ST
RENO NV
89502-2597
US

IV. Provider business mailing address

PO BOX 10153
RENO NV
89510-0153
US

V. Phone/Fax

Practice location:
  • Phone: 775-786-7200
  • Fax:
Mailing address:
  • Phone: 775-786-7200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number6194
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: