Provider Demographics
NPI:1225336100
Name:CHILDS, ZELLA CHRISTINE (MFT)
Entity Type:Individual
Prefix:
First Name:ZELLA
Middle Name:CHRISTINE
Last Name:CHILDS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 FUGGLES DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89441-5868
Mailing Address - Country:US
Mailing Address - Phone:775-770-0900
Mailing Address - Fax:
Practice Address - Street 1:623 W WASHINGTON ST STE A
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3837
Practice Address - Country:US
Practice Address - Phone:775-884-3600
Practice Address - Fax:775-884-3601
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01311106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist