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NPI Code Detail

MEDICARE: DR. TARA RENEE SNYDER BORSH PSY.D., LP

MEDICARE: DR. TARA RENEE SNYDER BORSH PSY.D., LP
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
1103T00000XPsychologistPY0786NV

General Provider Information

NPI Number : 1801077383
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TARA RENEE SNYDER BORSH PSY.D., LP
Provider Business Mailing Address
First Line : 6460 MEDICAL CENTER ST, STE 140
Second Line : BOYS TOWN NEVADA, INC.
City : LAS VEGAS
State : NV
Zip : 89148-2420
Country : US
Telephone Number : 702-888-1340
Fax Number : 702-888-1342
Provider Business Practice Location Address
First Line : 8390 W WINDMILL LN STE 102-103
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-4420
Country : US
Telephone Number : 702-888-1340
Fax Number : 702-888-1342
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2007
Last Update Date : 07/25/2025

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