Individual
JAY MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLADC
Contact information
Practice address
124 S 24TH ST, SUITE 230, OMAHA, NE 68102-1226
(402) 978-5656
Mailing address
124 S 24TH ST, SUITE 230, OMAHA, NE 68102-1226
(402) 978-5656
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P768
NE
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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