Individual
MILDRED CASSANDRA TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PLMHP, LADC
Contact information
Practice address
1941 S 42ND ST STE 307, OMAHA, NE 68105-2939
(402) 970-8350
(888) 490-0210
Mailing address
1941 S 42ND ST STE 307, OMAHA, NE 68105-2939
(402) 979-8350
(888) 490-0210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1408
NE
101YM0800X
Mental Health Counselor
Primary
12709
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026379900
—
NE
Enumeration date
07/19/2016
Last updated
11/19/2021
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