Healthcare Provider Details

I. General information

NPI: 1134420060
Provider Name (Legal Business Name): MARIA L. SAENZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2010
Last Update Date: 09/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 CRESCENT DR
GERING NE
69341-1712
US

IV. Provider business mailing address

3350 10TH ST
GERING NE
69341-1724
US

V. Phone/Fax

Practice location:
  • Phone: 308-632-2540
  • Fax: 308-633-2650
Mailing address:
  • Phone: 308-635-3089
  • Fax: 308-633-2650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-1165
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-1165
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: