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NPI Code Detail

MEDICARE: MARIAH HERGOTT

MEDICARE:   MARIAH  HERGOTT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor10893NE
2101Y00000XCounselor2273NE

General Provider Information

NPI Number : 1184072027
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAH HERGOTT
Provider Business Mailing Address
First Line : 110 N 37TH ST STE 405
Second Line :
City : NORFOLK
State : NE
Zip : 68701-3283
Country : US
Telephone Number : 402-230-7576
Fax Number :
Provider Business Practice Location Address
First Line : 802 CUSTER AVE STE B
Second Line :
City : NORFOLK
State : NE
Zip : 68701-0859
Country : US
Telephone Number : 402-230-7576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2016
Last Update Date : 02/26/2025

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Directions to “ MARIAH HERGOTT ” Practice Location

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