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Individual

MS. JUDY L. GONNERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA

Contact information

Practice address
1919 S 40TH ST STE 212, LINCOLN, NE 68506-5248
(402) 441-9280
Mailing address
1919 S 40TH ST STE 212, LINCOLN, NE 68506-5248
(402) 441-9280

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2491
NE
101YP2500X
Professional Counselor
1353
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
236670
MIDLANDS INSURANCE #
NE
01
339315
VALUE OPTIONS #
NE
05
47075636926
NE
05
47075636998
NE
01
68506A008
TRICARE
NE
01
84078
BLUE CROSS & BLUE SHIELD
NE
Enumeration date
11/16/2006
Last updated
01/22/2008
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