Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | P-1768 | NE |
NPI | 1003432386 |
---|---|
Provider Name | Ms. Judi Scott |
First Address | Omaha, NE 68134-5619 |
Second Address | Omaha, NE 68134-5619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2020 |
Last Update Date | 13/06/2021 |