MEDICARE: DR. MANDRA LYNN RASMUSSEN-HALL PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TB0200X	Cognitive & Behavioral Psychologist	PY0536	NV

General Provider Information

NPI Number	:	1053523274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANDRA LYNN RASMUSSEN-HALL PH.D.

Provider Business Mailing Address
First Line	:	443 W PLUMB LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3766
Country	:	US
Telephone Number	:	775-853-2440
Fax Number	:	775-451-7274

Provider Business Practice Location Address
First Line	:	443 W PLUMB LN
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-3766
Country	:	US
Telephone Number	:	775-853-2440
Fax Number	:	775-451-7274

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	10/23/2023

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