Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 8598 | NE |
NPI | 1003070376 |
---|---|
Provider Name | Tracy J Weiland |
First Address | Lexington, NE 68850-1890 |
Second Address | Omaha, NE 68102-1226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |