Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 7518 | NE |
NPI | 1003030149 |
---|---|
Provider Name | Mrs. Stella Adachi Offodirinwa |
First Address | Lincoln, NE 68521-3764 |
Second Address | Lincoln, NE 68521-3764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1002523500 | (05) | NE |