Individual
KENYA JO SANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
1941 S 42ND ST STE 307, OMAHA, NE 68105-2939
(402) 979-8350
Mailing address
1941 S 42ND ST STE 307, OMAHA, NE 68105-2939
(402) 979-8350
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-1848
NE
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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