Provider Demographics
NPI:1477852002
Name:UNTHANK, KATHERINE W (PHD, CPC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:W
Last Name:UNTHANK
Suffix:
Gender:F
Credentials:PHD, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-4424
Mailing Address - Country:US
Mailing Address - Phone:775-742-1475
Mailing Address - Fax:775-828-1853
Practice Address - Street 1:507 W 6TH ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-4424
Practice Address - Country:US
Practice Address - Phone:775-742-1475
Practice Address - Fax:775-828-1853
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCP0012101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional