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Individual

DEAN ALLEN BALDERSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHP

Contact information

Practice address
314 S 14TH ST, SUITE 103, ORD, NE 68862-1762
(308) 730-2216
Mailing address
314 S 14TH ST, SUITE 103, ORD, NE 68862-1762
(308) 730-2216

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3163
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025378700
NE
Enumeration date
12/24/2007
Last updated
12/24/2007
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