Individual
KARMEN SUE VAN DE WALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 35TH AVE, COLUMBUS, NE 68601-4731
(402) 562-6767
Mailing address
1160 46TH AVE, COLUMBUS, NE 68601-3947
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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