Individual
PENNY LYNN SHALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PROVISIONAL LICENSE
Contact information
Practice address
614 N 4TH ST, ONEILL, NE 68763-1303
(402) 336-1306
Mailing address
208 E FREMONT ST, ONEILL, NE 68763-1844
(402) 336-7452
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13678
NE
Other
Enumeration date
10/26/2023
Last updated
10/26/2023
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