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General NPI Number Information
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NPI Number | 1346658523
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Entity Type | Organization
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Legal Business Name | SANDSTONE PSYCHOLOGICAL PRACTICE
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 07/31/2014
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Provider Practice Location Address
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Address Line | 660 FINCH ISLAND AVE
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City | HENDERSON
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State | NV
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Zip | 89015-6637
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Country | US
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Telephone | 702-738-4472
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Fax |
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Provider Business Mailing Address
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Address Line | 660 FINCH ISLAND AVE
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City | HENDERSON
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State | NV
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Zip | 89015-6637
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Country | US
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Telephone | 702-738-4472
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. JANELL M MIHELIC
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Credential | PH.D.
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Telephone | 702-738-4472
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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 | PY0721
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PY0722
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License Number State | NV
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