Individual
KIMBERLY DIANE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP, LADC
Contact information
Practice address
13917 GOLD CIR, OMAHA, NE 68144-2359
(402) 991-9630
Mailing address
2236 GREGG RD APT 6, BELLEVUE, NE 68123-4069
(402) 669-2821
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
898
NE
101YM0800X
Mental Health Counselor
Primary
4107
NE
Other
Enumeration date
01/03/2021
Last updated
02/02/2023
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