Individual
SALLY W. FINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIMHP, MSW, MA
Contact information
Practice address
11414 W CENTER RD, SUITE 220, OMAHA, NE 68144-4487
(402) 330-4014
(402) 334-2930
Mailing address
2520 S 98TH AVE, OMAHA, NE 68124-1910
(402) 391-0589
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
769
NE
1041C0700X
Clinical Social Worker
Primary
79
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
238567
MIDLANDS CHOICE
NE
05
—
47068631113
—
NE
01
—
82383
BLUE CROSS BLUE SHIELD
NE
Enumeration date
12/07/2006
Last updated
09/07/2012
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