Individual
RAVEN KNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP
Contact information
Practice address
230 E 22ND ST, FREMONT, NE 68025-2661
(402) 727-1592
Mailing address
230 E 22ND ST STE 4, FREMONT, NE 68025-2661
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13275
NE
Other
Enumeration date
01/26/2023
Last updated
01/26/2023
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