Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 767 | IA |
NPI | 1003031758 |
---|---|
Provider Name | Susan K Narduccie |
First Address | Omaha, NE 68164-7130 |
Second Address | Shenandoah, IA 51601-1539 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |