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Individual

ANDY WOLLBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHP, CPC

Contact information

Practice address
2041 E 56TH ST, KEARNEY, NE 68847-4179
(308) 236-7145
(308) 236-7150
Mailing address
2041 E 56TH ST, KEARNEY, NE 68847-4179
(308) 236-7145
(308) 236-7150

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2375
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47079796127
NE
Enumeration date
05/08/2007
Last updated
07/09/2007
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