Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 10132 | NE |
NPI | 1003239468 |
---|---|
Provider Name | Janice Sherman |
First Address | Glenvil, NE 68941 |
Second Address | Glenvil, NE 68941-2761 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2014 |
Last Update Date | 21/01/2014 |