Individual
JACKIE RAE MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15704 CORBY ST, OMAHA, NE 68116-2042
(402) 350-1107
Mailing address
15704 CORBY ST, OMAHA, NE 68116-2042
(402) 350-1107
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2463
NE
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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