Provider Demographics
NPI:1710322425
Name:ZMAILA, KATRINA (MFT INTERN)
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:
Last Name:ZMAILA
Suffix:
Gender:F
Credentials:MFT INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 IDEAL CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-9604
Mailing Address - Country:US
Mailing Address - Phone:775-741-8130
Mailing Address - Fax:
Practice Address - Street 1:502 E JOHN ST
Practice Address - Street 2:SUITE A
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-3099
Practice Address - Country:US
Practice Address - Phone:775-741-8130
Practice Address - Fax:775-883-9803
Is Sole Proprietor?:No
Enumeration Date:2013-05-08
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMI0431106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist