Provider Demographics
NPI:1003946237
Name:NETZLER, SERWIND OSGOOD BANCKS
Entity Type:Individual
Prefix:MR
First Name:SERWIND
Middle Name:OSGOOD BANCKS
Last Name:NETZLER
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 1:1010 SILVERANCH DR
Mailing Address - Street 2:
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89460-8684
Mailing Address - Country:US
Mailing Address - Phone:775-513-9421
Mailing Address - Fax:603-909-7935
Practice Address - Street 1:1001 MOUNTAIN ST
Practice Address - Street 2:SUITE 3-H
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3822
Practice Address - Country:US
Practice Address - Phone:775-445-7756
Practice Address - Fax:775-841-0304
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health