Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
Y | 103G00000X | Clinical Psychologist | PY0569 | NV |
Y | 103TC0700X | Clinical Psychologist | PY0569 | NV |
NPI | 1003065921 |
---|---|
Provider Name | Dr. George Deacon Shoenberger |
First Address | Reno, NV 89509-3355 |
Second Address | Reno, NV 89509-3355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2008 |
Last Update Date | 11/08/2014 |