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Individual

Inactive
Sole proprietor

Provider details

NPI number

Contact information

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2943
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1533
PROFESSIONAL COUNSELOR
NE
01
2943
MENTAL HEALTH PRACTIONER
NE
01
711
LICENSED INDEDENDENT MENTAL HEALTH PROVIDER
NE
Enumeration date
Last updated
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