Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 8357 | NE |
NPI | 1003058389 |
---|---|
Provider Name | Kate Anderson |
First Address | Omaha, NE 68114-2732 |
Second Address | Omaha, NE 68114-2732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8357 | LICENSE MENTAL HEALTH PRACTIONER (01) | NE |