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Individual

MRS. MEADOW MARIE SCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, LIMHP

Contact information

Practice address
415 E 23RD ST, SUITE 205, FREMONT, NE 68025-2393
(402) 995-9989
Mailing address
415 E 23RD ST, SUITE 205, FREMONT, NE 68025-2393
(402) 995-9989

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2549
NE
1041C0700X
Clinical Social Worker
1065
NE
174400000X
Specialist
Primary
651
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10024965800
NE
Enumeration date
06/15/2006
Last updated
03/30/2011
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