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Individual

MISS NICKOLE BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4525 N 36TH AVE, OMAHA, NE 68111-2251
(402) 451-5549
Mailing address
4525 N 36TH AVE, OMAHA, NE 68111-2251
(402) 451-5549

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NE

Other

Enumeration date
02/29/2012
Last updated
02/29/2012
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