| NPI | 1518239797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE MAYNARD CROCKETT Mental Health Therapist 402-484-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 834) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2013-05-13 |