Individual
LISA M. SHOUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDAC
Contact information
Practice address
4321 41ST ST, COLUMBUS, NE 68601-9414
(402) 562-8952
(402) 564-0611
Mailing address
4321 41ST ST, PO BOX 1028, COLUMBUS, NE 68601-9414
(402) 562-8952
(402) 564-0611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
875
NE
Other
Enumeration date
10/01/2010
Last updated
01/20/2015
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