| NPI | 1962762195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYLL PLAMER WILSON Psychologist 402-489-2218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NE 528) |
| Additional Taxonomies | 251S00000X (Licence: NE 766) |
| 251S00000X (Licence: NE 261) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |