Individual
MR. BRYCE THOMAS THULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11414 W CENTER RD, SUITE 220, OMAHA, NE 68144-4486
(402) 330-4014
Mailing address
1633 S 99TH ST, OMAHA, NE 68124-1007
(402) 393-0846
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1568
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47068631113
—
NE
Enumeration date
11/13/2006
Last updated
07/09/2007
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