Healthcare Provider Details

I. General information

NPI: 1902935661
Provider Name (Legal Business Name): HOWARD ROBERT QUILITCH PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2192 CAPRI LN
SPARKS NV
89434-2008
US

IV. Provider business mailing address

2192 CAPRI LN
SPARKS NV
89434-2008
US

V. Phone/Fax

Practice location:
  • Phone: 775-331-1127
  • Fax:
Mailing address:
  • Phone: 775-331-1127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number69
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: