Individual
KETURAH FENICLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSS
Contact information
Practice address
120 S 24TH ST, SUITE 100, OMAHA, NE 68102-1213
(402) 342-7007
(402) 591-5075
Mailing address
124 S 24TH ST, SUITE 230, OMAHA, NE 68102-1226
(402) 342-7007
(402) 591-5075
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NE
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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