Individual
DEB THREATS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
4719 PRESCOTT AVE, LINCOLN, NE 68506-5456
(402) 413-9147
(402) 261-7149
Mailing address
1200 VIRGINIA ST, LINCOLN, NE 68508-1057
(402) 405-4617
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-1927
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NE
Other
Enumeration date
02/28/2017
Last updated
04/03/2024
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