Individual
JESSICA GROENEWEG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 N 60TH ST, OMAHA, NE 68104-3402
(402) 554-0520
(402) 551-8797
Mailing address
3300 N 60TH ST, OMAHA, NE 68104-3402
(402) 554-0520
(402) 551-8797
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10822
NE
104100000X
Social Worker
7051
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025225100
—
NE
05
—
47037661200
—
NE
Enumeration date
03/23/2016
Last updated
03/23/2016
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