Individual
IVORY LAINE WELBOURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, MSW
Contact information
Practice address
7101 NEWPORT AVE, OMAHA, NE 68152-2164
(402) 572-2916
(402) 572-3544
Mailing address
7101 NEWPORT AVE, OMAHA, NE 68152-2164
(402) 572-2916
(402) 572-3544
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1125
NE
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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