Individual
THERON NEWELL DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., CCC-A
Contact information
Practice address
253 BARKLEY MEMORIAL CENTER, LINCOLN, NE 68583-0731
(402) 472-2068
Mailing address
253 BARKLEY MEMORIAL CENTER, LINCOLN, NE 68583-0731
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
20
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025369300
—
NE
05
—
10025369400
—
NE
01
—
20
NE AUDIOLOGY LICENSE
NE
01
—
37025
BCBS
NE
Enumeration date
04/11/2006
Last updated
07/11/2007
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