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MR. C GRANT STORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMHP

Contact information

Practice address
10708 CORBY CIR, OMAHA, NE 68164-3583
(402) 891-8300
(402) 891-8301
Mailing address
10708 CORBY CIR, OMAHA, NE 68164-3583
(402) 891-8300
(402) 891-8301

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2341
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47080935726
NE
01
84304
BLUE CROSS BLUE SHIELD
NE
Enumeration date
11/22/2006
Last updated
07/08/2007
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