Individual
MANDY J LUETTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP
Contact information
Practice address
444 S 44TH ST, OMAHA, NE 68131-3727
(402) 559-6408
(402) 559-5737
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
(402) 559-6408
(402) 559-5737
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9846
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9846
NE STATE LICENSE
NE
Enumeration date
01/18/2013
Last updated
01/18/2013
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