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Individual

KELILYN WALTENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1905 E. FORTH ST, RENO, NV 89512
(775) 786-4673
Mailing address
2362 WABASH CIR, SPARKS, NV 89434-8840
(775) 351-6804

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
08067-IG
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
08066-LCI
101YP2500X
Professional Counselor
Primary
CI5527
NV

Other

Enumeration date
08/01/2024
Last updated
11/07/2025
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