Provider Demographics
NPI:1386473957
Name:WACHSMUTH, CYNTHIA E (NACADC)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:E
Last Name:WACHSMUTH
Suffix:
Gender:F
Credentials:NACADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 RIO VISTA DR
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89406-9408
Mailing Address - Country:US
Mailing Address - Phone:775-423-3634
Mailing Address - Fax:775-428-6359
Practice Address - Street 1:999 RIO VISTA DR
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-9408
Practice Address - Country:US
Practice Address - Phone:775-423-3634
Practice Address - Fax:775-428-6359
Is Sole Proprietor?:No
Enumeration Date:2024-07-31
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV02487-I101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)