Individual
STACY A KOSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8201 NORTHWOODS DR, LINCOLN, NE 68505-3092
(402) 465-5600
(402) 437-0854
Mailing address
3901 PINE LAKE RD, LINCOLN, NE 68516-5497
(402) 465-5600
(402) 437-0854
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
280
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47079049100
—
NE
Enumeration date
06/18/2007
Last updated
09/12/2007
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