Organization
EATING DISORDER RECOVERY SERVICES PROFESSIONAL CORPORATION
Active
Organization
EATING DISORDER RECOVERY SERVICES PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL FREDERICK GUNNARSON PH.D. (PRESIDENT)
(775) 287-2706
Entity
Organization
Contact information
Practice address
5365 MAE ANNE AVE, SUITE B-10, RENO, NV 89523-1840
(775) 287-2706
Mailing address
PO BOX 2866, RENO, NV 89505-2866
(775) 287-2706
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0360
NV
Other
Enumeration date
11/11/2008
Last updated
11/11/2008
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