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Individual

MR. GERALD LOU MAYO III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSW, PLMHP

Contact information

Practice address
917 W 21ST ST, SOUTH SIOUX CITY, NE 68776-2652
(402) 494-3337
(402) 494-3356
Mailing address
917 W 21ST ST, P.O. BOX 355, SOUTH SIOUX CITY, NE 68776-2652
(402) 494-3337
(402) 494-3356

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9719
NE
1041C0700X
Clinical Social Worker
6822
NE

Other

Enumeration date
08/03/2012
Last updated
02/18/2014
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