Individual
MR. MICHEAL MILES POP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.H.P.
Contact information
Practice address
329 J ST, LOUP CITY, NE 68853-8118
(308) 745-0329
(308) 745-0329
Mailing address
PO BOX 333, LOUP CITY, NE 68853-0333
(308) 745-0329
(308) 745-0329
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1303
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025370600
—
NE
01
—
808338000
MAGELLAN -USER NAME
NE
01
—
85614
BLUE CROSS BLUE SHIELD NE
NE
Enumeration date
11/01/2006
Last updated
07/08/2007
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