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Individual

SHEENA MARIE MIKOLOYCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS PSYCHOLOGY

Contact information

Practice address
511 N D ST, FREMONT, NE 68025-5051
(402) 720-6853
(402) 727-0779
Mailing address
511 N D ST, FREMONT, NE 68025-5051
(402) 720-6853
(402) 727-0779

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
3801
NE
101YM0800X
Mental Health Counselor
Primary
4745
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13808662
CAQH
NE
05
600931841
NE
Enumeration date
05/23/2007
Last updated
11/19/2024
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