Individual
MARY LOU PAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., L.P.
Contact information
Practice address
1550 S 70TH ST, SUITE 101, LINCOLN, NE 68506-1576
(402) 488-0077
(402) 488-0017
Mailing address
1550 S 70TH ST, SUITE 101, LINCOLN, NE 68506-1576
(402) 488-0077
(402) 488-0017
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
559
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025451300
—
NE
01
—
5156
MIDLANDS CHOICE
NE
01
—
80077
BLUE CROSS BLUE SHIELD
NE
01
—
98378
BCBS AUXILIARY
NE
Enumeration date
07/28/2006
Last updated
07/09/2007
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