Individual
JESSICA MARIE GROSSNICKLAUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2001 PINE LAKE RD STE 200, LINCOLN, NE 68512-3604
(402) 261-8313
Mailing address
2001 PINE LAKE RD STE 200, LINCOLN, NE 68512-3604
(402) 261-8313
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1082
NE
103T00000X
Psychologist
T-LMLP2938
KS
Other
Enumeration date
08/27/2019
Last updated
08/09/2023
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