Individual
LUCILLE CRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
749 NEW HAMPSHIRE ST, LINCOLN, NE 68508-1150
(816) 803-5595
Mailing address
749 NEW HAMPSHIRE ST, LINCOLN, NE 68508-1150
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB803761
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67238824
SCHOOL ID
—
Enumeration date
07/22/2022
Last updated
07/22/2022
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