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Individual

KYLE MABUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMHP, LPC

Contact information

Practice address
11615 I ST, OMAHA, NE 68137-1211
(402) 504-9056
Mailing address
11615 I ST, OMAHA, NE 68137-1211
(402) 504-9056

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4324
NE
101YP2500X
Professional Counselor
2104
NE

Other

Enumeration date
02/05/2014
Last updated
03/15/2024
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