Provider Demographics
NPI:1154514735
Name:MARSH, GLADYS AMILEE (MS)
Entity type:Individual
Prefix:
First Name:GLADYS
Middle Name:AMILEE
Last Name:MARSH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:AMI
Other - Middle Name:
Other - Last Name:MARSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT, LCADC
Mailing Address - Street 1:1055 AMBASSADOR DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1737
Mailing Address - Country:US
Mailing Address - Phone:775-232-4601
Mailing Address - Fax:
Practice Address - Street 1:5250 NEIL RD STE 301B-2
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6571
Practice Address - Country:US
Practice Address - Phone:775-232-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01126106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist