Healthcare Provider Details

I. General information

NPI: 1386692895
Provider Name (Legal Business Name): JAYNE KADING MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

547 S ARLINGTON AVE
RENO NV
89509-1504
US

IV. Provider business mailing address

547 S ARLINGTON AVE
RENO NV
89509-1504
US

V. Phone/Fax

Practice location:
  • Phone: 775-787-8002
  • Fax:
Mailing address:
  • Phone: 775-787-8002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0756
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: