Individual
MARY ANGELA PULIDO-BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1462 US HIGHWAY 395 N, GARDNERVILLE, NV 89410-5203
(775) 553-0668
(775) 319-5922
Mailing address
6700 N LINDER RD STE 156A, #331, MERIDIAN, ID 83646-6606
(775) 781-3122
(775) 319-5922
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0951
NV
Other
Enumeration date
05/21/2009
Last updated
01/19/2024
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