Organization
MARY P HASKINS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY P HASKINS LCSW, LMHP, LADC (LICENSED CLINICAL SOCIAL WORKER)
(402) 727-4886
Entity
Organization
Contact information
Practice address
1239 N PARK AVE, FREMONT, NE 68025-4172
(402) 727-4886
(402) 727-4146
Mailing address
1239 N PARK AVE, FREMONT, NE 68025-4172
(402) 727-4886
(402) 727-4146
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1369
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025687100
—
NE
Enumeration date
09/29/2010
Last updated
09/29/2010
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