Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 5557 | NE |
N | 101YP2500X | Professional Counselor |
NPI | 1003399189 |
---|---|
Provider Name | Anteshia Zulkoski |
First Address | Kearney, NE 68847-8134 |
Second Address | Kearney, NE 68847-8134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2018 |
Last Update Date | 24/03/2021 |