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1174832547
LISA M. SHOUP
COLUMBUS, NE
NPI
1174832547
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NE 875)
Enumeration Date
2010-10-01
Last Update Date
2015-01-20
Business Address
-- LISA M. SHOUP LDAC
4321 41ST ST
COLUMBUS, NE 68601-9414
Phone number: 402-562-8952
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Mailing Address
-- LISA M. SHOUP LDAC
4321 41ST ST PO BOX 1028
COLUMBUS, NE 68601-9414
Phone number: 402-562-8952
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