Basic Information
| Provider Information | |||||||||
| NPI: | 1003946237 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NETZLER | ||||||||
| FirstName: | SERWIND | ||||||||
| MiddleName: | OSGOOD BANCKS | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1010 SILVERANCH DR | ||||||||
| Address2: | |||||||||
| City: | GARDNERVILLE | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894608684 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7755139421 | ||||||||
| FaxNumber: | 6039097935 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 MOUNTAIN ST | ||||||||
| Address2: | SUITE 3-H | ||||||||
| City: | CARSON CITY | ||||||||
| State: | NV | ||||||||
| PostalCode: | 897033822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7754457756 | ||||||||
| FaxNumber: | 7758410304 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.