Individual
MYRA JEANNE KWAST-LIPKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP
Contact information
Practice address
721 W 6TH AVE, RED CLOUD, NE 68970-2278
(402) 746-5614
Mailing address
710 E 10TH ST, SUPERIOR, NE 68978-2305
(402) 879-3647
(402) 746-5684
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8145
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8145
STATE LISENSE
NE
Enumeration date
06/20/2007
Last updated
07/08/2007
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