# RUDOLPH VON RAVENSBERG

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Basin Behavioral Health and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093131948
- **Authorized official:** RUDOLPH VON RAVENSBERG LMFT (PSYCHOTHERAPIST/OWNER)
- **Authorized official phone:** (775) 232-0399

## Contact information

- **Practice address:** 1325 AIRMOTIVE WAY, STE 175R, RENO, NV 89502-3275
- **Practice address phone:** (775) 453-4143
- **Mailing address:** 1325 AIRMOTIVE WAY, STE 175R, RENO, NV 89502-3275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 1098 | NV | Yes |

## Other

- **Enumeration date:** 03/14/2014
- **Last updated:** 03/14/2014