MEDICARE: LINDSEY BOCCHIERI RICCIARDI PHD

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	103TC0700X	Clinical Psychologist	PY0529	NV

General Provider Information

NPI Number	:	1982851465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY BOCCHIERI RICCIARDI PHD

Provider Business Mailing Address
First Line	:	5572 S FORT APACHE RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-503-5592
Fax Number	:	702-974-1268

Provider Business Practice Location Address
First Line	:	5572 S FORT APACHE RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-503-5592
Fax Number	:	702-974-1268

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

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	07/10/2023

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