Organization
PRAIRIE PSYCHOLOGICAL SERVICES, INC
Active
Parent organization
PRAIRIE PSYCHOLOGICAL SERVICES, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRAIRIE PSYCHOLOGICAL SERVICES, INC
Authorized official
TWILA L PRESTON PHD (CLINICAL PSYCHOLOGIST/OWNER)
(402) 494-0040
Entity
Organization
Contact information
Practice address
219 MAIN ST, STE 2, WAYNE, NE 68787-1924
(402) 494-0040
Mailing address
625 E 39TH ST, SOUTH SIOUX CITY, NE 68776-3445
(402) 494-0040
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
531
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
293374000
—
NE
Enumeration date
03/14/2014
Last updated
03/14/2014
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