Individual
SANDRA GABRIEL LUSTRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2424 S LOCUST ST STE C, GRAND ISLAND, NE 68801-8316
(086) 755-3013
Mailing address
307 W STOLLEY PARK RD APT 1, GRAND ISLAND, NE 68801-7470
(402) 705-4089
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3161
NE
Other
Enumeration date
04/12/2022
Last updated
11/08/2022
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