Individual
SHANNON LUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2908 W 39TH ST STE B, KEARNEY, NE 68845
(308) 237-0391
Mailing address
2908 W 39TH ST STE B, KEARNEY, NE 68845-1245
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1554
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371749606
—
NE
Enumeration date
04/23/2014
Last updated
06/25/2018
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