Individual
TRACEY DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
721 K ST, LINCOLN, NE 68508-2949
(402) 477-3951
(402) 477-3922
Mailing address
721 K ST, LINCOLN, NE 68508-2949
(402) 477-3951
(402) 477-3922
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
60758
NE
Other
Enumeration date
09/15/2016
Last updated
09/15/2016
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