Individual
MRS. MIRANDA ELLEN STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHP, PLADC
Contact information
Practice address
110 N BAILEY, NORTH PLATTE, NE 69101
(308) 534-6029
(308) 534-6961
Mailing address
110 N BAILEY, NORTH PLATTE, NE 69101
(308) 534-6029
(308) 534-6961
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-877
NE
101YM0800X
Mental Health Counselor
Primary
3892
NE
101YM0800X
Mental Health Counselor
9088
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025777100
—
NE
Enumeration date
05/12/2010
Last updated
09/09/2011
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