Organization Name: | GENOA PSYCHOLOGICAL SERVICES, PC |
NPI Number: | 1548419153 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RHONDA L SOMERHISER (PRESIDENT) |
Mailing Address: | 415 Willard Ave Genoa |
State: | NE US |
Postal Code: | 686403044 |
Phone Number: | 4029480479 |
Fax Number: | |
NPI Enumeration Date: | 09/18/2008 |
NPI Last Update Date: | 05/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 692 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |