Organization
CHILD AND FAMILY BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUDITH GAIL BOTHERN PH.D. (PRESIDENT)
(402) 483-6575
Entity
Organization
Contact information
Practice address
7441 O ST, SUITE 300, LINCOLN, NE 68510-2468
(402) 483-6575
(402) 483-6587
Mailing address
7441 O ST, SUITE 300, LINCOLN, NE 68510-2468
(402) 483-6575
(402) 483-6587
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
314
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08124
BLUE CROSS BLUE SHIELD
NE
01
—
4295
MIDLANDS CHOICE
NE
Enumeration date
11/02/2006
Last updated
08/22/2020
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