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Individual
MRS. LEANN MAXINE TICE
Active
Individual
MRS. LEANN MAXINE TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.MHP, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3704
NE
101YM0800X
Mental Health Counselor
8555
NE
101YP2500X
Professional Counselor
1843
NE
Other
Enumeration date
02/27/2008
Last updated
04/08/2010
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