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Individual

KEN G. MUNZESHEIMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHP, CMSW

Contact information

Practice address
9239 W CENTER RD, SUITE # 207, OMAHA, NE 68124-1900
(402) 354-8000
Mailing address
2017 S 135TH AVE, OMAHA, NE 68144-2403

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
502
NE
101Y00000X
Counselor
659
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
502
LMHP LICENSE
NE
01
659
CMSW LICENSE
NE
Enumeration date
03/26/2007
Last updated
07/08/2007
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