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Individual

LACEY TAYLOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLMHP, PMSW

Contact information

Practice address
10846 OLD MILL RD STE 5, OMAHA, NE 68154-2655
(402) 871-1002
Mailing address
408 N MAIN ST, HOOPER, NE 68031-3022
(402) 278-0264

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11336
NE
1041C0700X
Clinical Social Worker
7202
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11336
NOT AN INSURANCE PROVIDER AT THIS TIME
NE
Enumeration date
12/01/2017
Last updated
12/01/2017
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