MEDICARE: DR. DANA ANNE GIONTA 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	103T00000X	Psychologist	002665	CT
2	103T00000X	Psychologist
3	103T00000X	Psychologist	PS01784	RI
4	103T00000X	Psychologist		NV

General Provider Information

NPI Number	:	1629108394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANA ANNE GIONTA PH.D.

Provider Business Mailing Address
First Line	:	9353 W TWAIN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6861
Country	:	US
Telephone Number	:	401-524-0090
Fax Number	:	401-444-6912

Provider Business Practice Location Address
First Line	:	9353 W TWAIN AVE
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-6861
Country	:	US
Telephone Number	:	401-524-0090
Fax Number	:	401-444-6912

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

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	02/15/2023

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