Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0200X | Forensic Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1164446605 |
---|---|
Provider Name | Dr. Leland Carl Zlomke |
First Address | Lincoln, NE 68516-6356 |
Second Address | Beatrice, NE 68310-4009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 14/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
245672 | MIDLANDS CHOICE (01) | NE |
49038 | BCBS (01) | NE |
90095 | BCBS AUXILLARY (01) | NE |
P00963834 | MEDICARE RAILROAD (01) | NE |