Individual
MRS. SHANNON MICHELLE MOTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
130 N. 39TH ST., OMAHA, NE 68131
(402) 558-7088
(402) 558-7133
Mailing address
130 N 39TH ST, OMAHA, NE 68131-2307
(402) 558-7088
(402) 558-7133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1068
NE
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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