Geriann T Dillender, PSY.D

Individual provider Active NPI Clinical Psychologist · Little Rock Afb, AR

NPI 1487697165 · NPPES record last updated Jun 27, 2019

Key facts

NPI
1487697165
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Psychologist 103TC0700X
License
MO2012014235 (MO)
Practice address
1090 Arnold Dr
Little Rock Afb, AR 72099-6600
Phone
(501) 987-3080
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
MO2012014235MOMDClinical Psychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X MO2012014235 MO Yes

Addresses

Primary practice location

1090 Arnold Dr
Little Rock Afb, AR 72099-6600

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-3808

Other practice location 1

4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-3808

Other providers in Little Rock Afb, AR

All providers in Little Rock Afb, AR · Clinical Psychologist in Arkansas

Sources for this page

Verify at the official NPI Registry.