Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 144 | NE |
NPI | 1003020124 |
---|---|
Provider Name | Mrs. Patricia Lynn Branchowd |
First Address | Lincoln, NE 68516 |
Second Address | Lincoln, NE 68516 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |