Individual
MARK PHILO SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2780 S JONES BLVD STE 108, LAS VEGAS, NV 89146-5625
(702) 606-3295
Mailing address
2780 S JONES BLVD STE 108, LAS VEGAS, NV 89146-5625
(702) 606-3295
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY0780
NV
103TS0200X
School Psychologist
Primary
—
—
Other
Enumeration date
04/03/2008
Last updated
08/04/2016
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