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General NPI Number Information
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NPI Number | 1417714619
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Entity Type | Organization
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Legal Business Name | DANA GIONTA LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 9353 W TWAIN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89147-6861
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Country | US
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Telephone | 401-524-0090
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Fax |
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Provider Business Mailing Address
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Address Line | 9353 W TWAIN AVE
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City | LAS VEGAS
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State | NV
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Zip | 89147-6861
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Country | US
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Telephone | 401-524-0090
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Fax |
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | DANA GIONTA
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Credential | PH.D
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Telephone | 401-524-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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