Organization
SHIODE PSYCHOTHERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL T SHIODE PH.D. (PRESIDENT)
(702) 384-4110
Entity
Organization
Contact information
Practice address
501 S. RANCHO DR., STE I-64, LAS VEGAS, NV 89106
(702) 384-4110
(702) 384-7954
Mailing address
501 S. RANCHO DR., STE I-64, LAS VEGAS, NV 89106
(702) 384-4110
(702) 384-7954
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0244
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002602062
—
NV
Enumeration date
03/07/2007
Last updated
06/19/2009
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