Organization
TEC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND VICTOR BURKE PHD (PRESIDENT)
(402) 676-2069
Entity
Organization
Contact information
Practice address
3623 S 114TH ST, OMAHA, NE 68144-4604
(402) 676-2069
Mailing address
3623 S 114TH ST, OMAHA, NE 68144-4604
(402) 676-2069
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4130
NE
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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