Provider Demographics
NPI:1053523274
Name:RASMUSSEN-HALL, MANDRA LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:MANDRA
Middle Name:LYNN
Last Name:RASMUSSEN-HALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 W PLUMB LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3766
Mailing Address - Country:US
Mailing Address - Phone:775-853-2440
Mailing Address - Fax:775-451-7274
Practice Address - Street 1:443 W PLUMB LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3766
Practice Address - Country:US
Practice Address - Phone:775-853-2440
Practice Address - Fax:775-451-7274
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY0536103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral