Individual
BAILIE JADE STAAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
17 HEATHER RD, GERING, NE 69341-1741
(308) 641-3646
Mailing address
17 HEATHER RD, GERING, NE 69341-1741
(308) 641-3646
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NE
Other
Enumeration date
10/31/2024
Last updated
10/31/2024
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