Individual
CODY BONERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5321 S 138TH ST, OMAHA, NE 68137
(402) 895-4000
(866) 895-8248
Mailing address
5321 S 138TH ST, OMAHA, NE 68137-2913
(402) 895-4000
(866) 895-8248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001611
IA
101YM0800X
Mental Health Counselor
Primary
1860
NE
Other
Enumeration date
04/16/2013
Last updated
11/20/2018
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