Provider Demographics
NPI:1427791094
Name:AMBER E TIMBERLAKE
Entity type:Organization
Organization Name:AMBER E TIMBERLAKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:E
Authorized Official - Last Name:TIMBERLAKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-391-5271
Mailing Address - Street 1:PO BOX 214
Mailing Address - Street 2:
Mailing Address - City:FALLON
Mailing Address - State:NV
Mailing Address - Zip Code:89407-0214
Mailing Address - Country:US
Mailing Address - Phone:775-294-6526
Mailing Address - Fax:
Practice Address - Street 1:40 E CENTER ST STE 12
Practice Address - Street 2:
Practice Address - City:FALLON
Practice Address - State:NV
Practice Address - Zip Code:89406-3474
Practice Address - Country:US
Practice Address - Phone:775-294-6526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty