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General NPI Number Information
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NPI Number | 1063894202
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Entity Type | Organization
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Legal Business Name | IAN L PRITCHARD LLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 1 E LIBERTY ST SUITE 600
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City | RENO
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State | NV
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Zip | 89501-2110
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Country | US
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Telephone | 775-525-0010
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Fax | 775-996-3287
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Provider Business Mailing Address
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Address Line | 6170 RIDGEVIEW CT SUITE C
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City | RENO
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State | NV
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Zip | 89519-6324
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Country | US
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Telephone | 775-200-0626
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Fax | 775-825-8277
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Authorized Official
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Title or Position | OWNER / MANAGING MEMBER
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Name | DR. IAN L PRITCHARD
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Credential | PH.D.
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Telephone | 775-200-0626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY0657
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | PY0657
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License Number State | NV
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