Provider Demographics
NPI:1760760144
Name:KOMPANIEZ-DUNIGAN, ELYSSE JIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELYSSE
Middle Name:JIL
Last Name:KOMPANIEZ-DUNIGAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELYSSE
Other - Middle Name:
Other - Last Name:KOMPANIEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6121 LAKESIDE DR STE 230
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-8527
Mailing Address - Country:US
Mailing Address - Phone:775-786-7881
Mailing Address - Fax:
Practice Address - Street 1:6121 LAKESIDE DR STE 230
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-8527
Practice Address - Country:US
Practice Address - Phone:775-786-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-02
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPY1036103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist