=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942449806
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RICHARD H PRATT PHD LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2009
-----------------------------------------------------
Last Update Date | 04/13/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 701 N GREEN VALLEY PKWY # 293
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89074-6177
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-251-0044
-----------------------------------------------------
Fax | 702-566-3301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 284-C E LAKE MEAD PKWY
-----------------------------------------------------
City | HENDERSON
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89015-6433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-251-0044
-----------------------------------------------------
Fax | 702-566-3301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RICHARD H PRATT
-----------------------------------------------------
Credential | PHD
-----------------------------------------------------
Telephone | 702-251-0044
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------