Doctor Name: | MR. SERWIND OSGOOD BANCKS NETZLER |
NPI Number: | 1003946237 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1001 Mountain St Suite 3-h Carson City, NV - 897033822 |
Business Phone Number: | 7754457756 |
Business Fax Number: | 7758410304 |
Mailing Address: | 1010 Silveranch Dr, GARDNERVILLE |
State: | NV |
Postal Code: | 894608684 |
Phone Number: | 7755139421 |
Fax Number: | 6039097935 |
NPI Enumeration Date: | 03/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |