Provider Demographics
NPI:1831275114
Name:ZELLERS, KATHLEEN ANN (MFT,PHD)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANN
Last Name:ZELLERS
Suffix:
Gender:F
Credentials:MFT,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3176 MAJESTIC SHADOWS AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3042
Mailing Address - Country:US
Mailing Address - Phone:702-630-8865
Mailing Address - Fax:702-837-6219
Practice Address - Street 1:3176 MAJESTIC SHADOWS AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3042
Practice Address - Country:US
Practice Address - Phone:702-630-8865
Practice Address - Fax:702-837-6219
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVR04348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist