Provider Demographics
NPI:1457795932
Name:VOLLBERG, DONNA M
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:VOLLBERG
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 1:2106 ROUNDHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4217
Mailing Address - Country:US
Mailing Address - Phone:775-359-1130
Mailing Address - Fax:
Practice Address - Street 1:620 E PLUMB LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-3536
Practice Address - Country:US
Practice Address - Phone:775-825-3043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor