Healthcare Provider Details

I. General information

NPI: 1811128523
Provider Name (Legal Business Name): AMANDA MARIE CUE PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 07/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5020 FIR HOLLOW LN
LINCOLN NE
68516-5318
US

IV. Provider business mailing address

5020 FIR HOLLOW LN
LINCOLN NE
68516-5318
US

V. Phone/Fax

Practice location:
  • Phone: 402-499-8754
  • Fax:
Mailing address:
  • Phone: 402-499-8754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number8635
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: