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General NPI Number Information
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NPI Number | 1720691074
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Entity Type | Organization
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Legal Business Name | RITA A. CARLSON, PSY.D., PLLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 1201 TERMINAL WAY STE 111
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City | RENO
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State | NV
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Zip | 89502-3398
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Country | US
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Telephone | 775-657-8566
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Fax |
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Provider Business Mailing Address
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Address Line | 191 SHADY GROVE LN
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City | DAYTON
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State | NV
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Zip | 89403-6364
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Country | US
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Telephone | 775-315-2980
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | DR. RITA A CARLSON
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Credential | PSY.D.
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Telephone | 775-315-2980
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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 |
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License Number State |
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