Individual
KELLY THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLMHP, PLADC
Contact information
Practice address
708 SUNSET BLVD, PALMYRA, NE 68418-4136
(402) 335-7945
Mailing address
721 K ST, LINCOLN, NE 68508-2949
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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