Provider Demographics
NPI:1114526423
Name:CAMP, KADI
Entity Type:Individual
Prefix:
First Name:KADI
Middle Name:
Last Name:CAMP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 MOUNT ROSE ST APT 16
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3448
Mailing Address - Country:US
Mailing Address - Phone:775-386-4171
Mailing Address - Fax:
Practice Address - Street 1:850 MILL ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1413
Practice Address - Country:US
Practice Address - Phone:775-538-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder