Individual
MRS. KRISA ESTELLA GRAYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
4200 N 30TH ST, OMAHA, NE 68111-2424
(402) 880-9333
Mailing address
4402 PINKNEY ST, OMAHA, NE 68111-2530
(402) 880-9333
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-1826
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000123
NO CLIENTS TO DATE
—
Enumeration date
06/03/2022
Last updated
06/03/2022
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