Healthcare Provider Details
I. General information
NPI: 1891385951
Provider Name (Legal Business Name): DAVOR NICOLAS ZINK PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/22/2021
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
85 KIRMAN AVE STE 200
RENO NV
89502-1340
US
IV. Provider business mailing address
1155 MILL ST # MCM14
RENO NV
89502-1576
US
V. Phone/Fax
- Phone: 775-982-2862
- Fax: 775-982-2865
- Phone: 775-982-5262
- Fax: 775-982-2865
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY0989 |
| License Number State | NV |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103G00000X |
| Taxonomy | Clinical Neuropsychologist |
| License Number | PY0989 |
| License Number State | NV |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: