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General NPI Number Information
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NPI Number | 1295938561
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Entity Type | Individual
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Provider Name | DUDLEY GONET LUKE PHD
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Gender | Male
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2340 PASEO DEL PRADO SUITE D307
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City | LAS VEGAS
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State | NV
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Zip | 89102
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Country | US
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Telephone | 702-423-4102
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Fax | 702-486-5896
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Provider Business Mailing Address
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Address Line | 8550 WEST DESERT INN SUITE 102-275
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City | LAS VEGAS
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State | NV
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Zip | 89117
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Country | US
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Telephone | 702-423-4102
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Fax | 701-486-5896
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0480
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY15951
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License Number State | CA
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