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Individual

DR. MARK SHRIVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D

Contact information

Practice address
985450 NEBRASKA MED CTR, OMAHA, NE 68198-5450
(402) 559-8943
Mailing address
985450 NEBRASKA MED CTR, OMAHA, NE 68198-5450
(402) 559-8943

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
412
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025287200
NE
Enumeration date
10/26/2006
Last updated
07/08/2007
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