Healthcare Provider Details

I. General information

NPI: 1992861405
Provider Name (Legal Business Name): SANDRA GAYE DELEHANTY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 BIG BEND RANCH RD NEVADA SKIES YOUTH WELLNESS CENTER
WADSWORTH NV
89442
US

IV. Provider business mailing address

PO BOX 280 NEVADA SKIES YOUTH WELLNESS CENTER
WADSWORTH NV
89442-0280
US

V. Phone/Fax

Practice location:
  • Phone: 775-352-6847
  • Fax: 775-575-3180
Mailing address:
  • Phone: 775-352-6847
  • Fax: 775-575-3180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: