Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 3925 | NE |
N | 101YP2500X | Professional Counselor | 1945 | NE |
N | 102L00000X | Psychologist | 3925 | NE |
N | 103T00000X | Psychologist | 3925 | NE |
NPI | 1003121005 |
---|---|
Provider Name | Dr. Alan Luis Hensley |
First Address | Omaha, NE 68137-2315 |
Second Address | Omaha, NE 68137-2315 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2010 |
Last Update Date | 18/07/2011 |