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Individual

DR. JEROMY A. WARNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
835 S BURLINGTON AVE, SUITE 108, HASTINGS, NE 68901-6960
(402) 463-7711
(402) 461-5099
Mailing address
835 S BURLINGTON AVE, SUITE 108, HASTINGS, NE 68901-6960
(402) 463-7711
(402) 461-5099

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
740
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
330
PROVISIONALLY LICENSED PSYCHOLOGIST
NE
05
47037877935
NE
01
740
STATE LICENSE PSYCHOLOGIST
NE
01
7596
PROVISIONAL MENTAL HEALTH PRACTITIONER
NE
Enumeration date
04/13/2009
Last updated
04/07/2010
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