Provider Demographics
NPI:1629108394
Name:GIONTA, DANA ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANA
Middle Name:ANNE
Last Name:GIONTA
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 1:9353 W TWAIN AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89147-6861
Mailing Address - Country:US
Mailing Address - Phone:401-524-0090
Mailing Address - Fax:401-444-6912
Practice Address - Street 1:9353 W TWAIN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89147-6861
Practice Address - Country:US
Practice Address - Phone:401-524-0090
Practice Address - Fax:401-444-6912
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002665103T00000X
103T00000X
RIPS01784103T00000X
NV103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT680001778Medicare ID - Type Unspecified