Individual
JUSTIN MARK REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLADC
Contact information
Practice address
600 N COTNER BLVD STE 119, LINCOLN, NE 68505-2343
(402) 261-6667
Mailing address
600 N COTNER BLVD STE 119, LINCOLN, NE 68505-2343
(402) 840-8339
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-2088
NE
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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