Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 2182 | NE |
NPI | 1184138117 |
---|---|
Provider Name | Lauren Renee Lindstrom |
First Address | Lincoln, NE 68522-1970 |
Second Address | Lincoln, NE 68522-1970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2017 |
Last Update Date | 29/11/2017 |