Individual
KERI NIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
1917 AVENUE A, SCOTTSBLUFF, NE 69361-2450
(308) 633-1390
Mailing address
1917 AVENUE A, SCOTTSBLUFF, NE 69361-2450
(308) 633-1390
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1292
NE
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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