Individual
MS. MARY ELLEN MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMHP
Contact information
Practice address
12020 SHAMROCK PLAZA, SUITE 200, OMAHA, NE 68154
(402) 616-7946
(402) 734-3990
Mailing address
4920 SO 30TH STREET, SUITE 103, OMAHA, NE 68107-1656
(402) 734-4110
(402) 734-3990
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1866
NE
101Y00000X
Counselor
Primary
654
NE
101YM0800X
Mental Health Counselor
1866
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47037660433
—
NE
Enumeration date
08/16/2006
Last updated
12/20/2016
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