Provider Demographics
NPI:1770948580
Name:SCHUENING, VANCE EDWARD
Entity type:Individual
Prefix:
First Name:VANCE
Middle Name:EDWARD
Last Name:SCHUENING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 FREEPORT BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-6259
Mailing Address - Country:US
Mailing Address - Phone:775-376-8248
Mailing Address - Fax:
Practice Address - Street 1:390 FREEPORT BLVD STE 4
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-6259
Practice Address - Country:US
Practice Address - Phone:775-376-8248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-21
Last Update Date:2015-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV8834OtherCERTIFICATION NUMBER