| NPI | 1962919092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMEKA JOHNSON Credentialing Manager 402-885-7672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 4954) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-05-26 |