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Individual

KELLY RENEE GWARTNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA PLMHP

Contact information

Practice address
1903 4TH CORSO, NEBRASKA, NE 68410-2601
(402) 873-5505
(402) 873-6374
Mailing address
8140 S CHERRYWOOD DRIVE, LINCOLN, NE 68510
(402) 327-8208

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7827
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025208500
NE
05
47052851501
NE
Enumeration date
11/02/2006
Last updated
07/08/2007
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