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Individual

JO ANN JEANNE SUKOVATY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLMHP

Contact information

Practice address
803 RIDGEWOOD AVE, GRAND ISLAND, NE 68803-9715
(308) 379-7339
Mailing address
803 RIDGEWOOD AVE, GRAND ISLAND, NE 68803-9715
(308) 379-7339

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9899
NE

Other

Enumeration date
03/21/2013
Last updated
03/21/2013
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