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Individual

MARY SELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3223 N 169TH ST, OMAHA, NE 68116-2650
(402) 813-2235
Mailing address
3223 N 169TH ST, OMAHA, NE 68116-2650
(402) 813-2235

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8613
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100252571-00
NE
01
805670000
MAGELLAN
NE
Enumeration date
05/29/2008
Last updated
05/29/2008
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