Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 072147 | IA |
NPI | 1003226812 |
---|---|
Provider Name | Mrs. Lori Kay Zoucha |
First Address | Omaha, NE 68144-4340 |
Second Address | Omaha, NE 68144-4340 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2014 |
Last Update Date | 01/05/2014 |