Individual
MRS. MELISSA ANN PEDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13460 WALSH DR, BOYS TOWN, NE 68010-7529
(402) 498-3358
(402) 498-3375
Mailing address
13460 WALSH DR, BOYS TOWN, NE 68010-7529
(402) 498-3358
(402) 498-3375
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4651
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025745300
—
NE
05
—
10026139700
—
NE
05
—
47037660631
—
NE
Enumeration date
05/25/2012
Last updated
10/10/2016
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