Provider Demographics
NPI:1851449268
Name:MILBECK, KATHLEEN A (MA, MFT)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:MILBECK
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 S SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89501-1912
Mailing Address - Country:US
Mailing Address - Phone:775-786-2424
Mailing Address - Fax:775-786-2449
Practice Address - Street 1:460 S SIERRA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89501-1912
Practice Address - Country:US
Practice Address - Phone:775-786-2424
Practice Address - Fax:775-786-2449
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0265106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV0265OtherMARRIAGE & FAMILY THERAPI