Individual
JAYNE FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLMHP
Contact information
Practice address
809 S 174TH ST, OMAHA, NE 68118-3540
(402) 991-8093
(402) 505-9726
Mailing address
1319 N 113TH CT APT 6004, OMAHA, NE 68154-5851
(402) 616-9225
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8638
NE
101YM0800X
Mental Health Counselor
—
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8638
STATE OF NEBRASKA
NE
Enumeration date
11/12/2009
Last updated
06/22/2021
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