# KIDWISE, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477907269
- **Authorized official:** TINA SCHNECKLOTH (BILLING SPECIALIST)
- **Authorized official phone:** (402) 504-4680

## Contact information

- **Practice address:** 8101 O ST STE 214, LINCOLN, NE 68510-2647
- **Practice address phone:** (402) 488-1032
- **Practice address fax:** (402) 484-8545
- **Mailing address:** 8101 O ST STE 214, LINCOLN, NE 68510-2647
- **Mailing address phone:** (402) 488-1032
- **Mailing address fax:** (402) 484-8545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 1174 | NE | Yes |

## Other

- **Enumeration date:** 04/18/2016
- **Last updated:** 04/18/2016