Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1477148146 |
---|---|
Provider Name | Amanda Jill Christenhusz |
First Address | Reno, NV 89506-4110 |
Second Address | Reno, NV 89502-1463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2021 |
Last Update Date | 04/03/2021 |