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Individual

PROF. DAVID ANTONUCCIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.H.D.

Contact information

Practice address
401 W 2ND ST STE 216, RENO, NV 89503-5353
(775) 784-6388
(775) 784-1428
Mailing address
401 W 2ND ST STE 235F, RENO, NV 89503-5353
(775) 784-1223
(775) 327-2006

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY104
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002616051
NV
Enumeration date
08/19/2006
Last updated
12/16/2009
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