Provider Demographics
NPI:1497065999
Name:ENEMARK, CADIE N
Entity Type:Individual
Prefix:MISS
First Name:CADIE
Middle Name:N
Last Name:ENEMARK
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 1:3275 LAKESHORE DR
Mailing Address - Street 2:
Mailing Address - City:WASHOE VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89704-9249
Mailing Address - Country:US
Mailing Address - Phone:775-849-3434
Mailing Address - Fax:775-849-3435
Practice Address - Street 1:3275 LAKESHORE DR
Practice Address - Street 2:
Practice Address - City:WASHOE VALLEY
Practice Address - State:NV
Practice Address - Zip Code:89704-9249
Practice Address - Country:US
Practice Address - Phone:775-849-3434
Practice Address - Fax:775-849-3435
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst