Individual
JILLIAN ANGELINE KELSEY-BERRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, PLADC
Contact information
Practice address
HWY 77/75, WINNEBAGO, NE 68071
(402) 878-2480
(402) 878-2204
Mailing address
PO BOX A, HWY 77/75, WINNEBAGO, NE 68071
(402) 878-2480
(402) 878-2204
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-931
NE
Other
Enumeration date
05/17/2011
Last updated
05/17/2011
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