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1164145090
JADE KELLY PRUSIA
OMAHA, NE
NPI
1164145090
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: 13108)
Enumeration Date
2022-09-26
Last Update Date
2022-09-26
Business Address
JADE KELLY PRUSIA PLMHP
5217 S 28TH ST
OMAHA, NE 68107-3402
Phone number: 402-715-5446
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Mailing Address
JADE KELLY PRUSIA PLMHP
2723 Q ST
OMAHA, NE 68107-3408
Phone number: 402-715-5446
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