Organization
CHILD AND FAMILY BEHAVIORAL HEALTH
Active
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
Update your record
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