Healthcare Provider Details

I. General information

NPI: 1396024493
Provider Name (Legal Business Name): ASSET OF NEBRASKA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2011
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

IV. Provider business mailing address

3801 UNION DR STE 206
LINCOLN NE
68516-6652
US

V. Phone/Fax

Practice location:
  • Phone: 402-489-2218
  • Fax: 402-489-3666
Mailing address:
  • Phone: 402-489-2218
  • Fax: 402-489-3666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. CARYLL PALMER WILSON
Title or Position: PRESIDENT
Credential: PHD
Phone: 402-489-2218