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General NPI Number Information
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NPI Number | 1578113601
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Entity Type | Organization
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Legal Business Name | RENO PSYCHOLOGICAL SERVICES, LLC
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 12/24/2019
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Provider Practice Location Address
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Address Line | 645 PLUMAS ST
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City | RENO
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State | NV
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Zip | 89509-1730
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Country | US
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Telephone | 775-657-9597
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Fax | 775-562-7570
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Provider Business Mailing Address
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Address Line | 645 PLUMAS ST
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City | RENO
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State | NV
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Zip | 89509-1730
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Country | US
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Telephone | 775-657-9597
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Fax | 775-562-7570
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Authorized Official
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Title or Position | OWNER
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Name | JOHN PAUL CRUM
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Credential | PSY,D,
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Telephone | 775-657-9597
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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 |
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License Number State |
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