Provider Demographics
NPI:1437040110
Name:CLEMENTS, KATHRYN LUCY
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LUCY
Last Name:CLEMENTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 EMBLEM ST
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-9171
Mailing Address - Country:US
Mailing Address - Phone:775-335-6953
Mailing Address - Fax:
Practice Address - Street 1:4745 CAUGHLIN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89519-0972
Practice Address - Country:US
Practice Address - Phone:775-335-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician