Healthcare Provider Details

I. General information

NPI: 1336396514
Provider Name (Legal Business Name): MELINDA KAY GRAHAM-HINNERS M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 08/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

602 N 20TH STE 1034 CREIGHTON UNIVERSITY, CENTER FOR HEALTH & COUNSELING
OMAHA NE
68178-0001
US

IV. Provider business mailing address

2500 CALIFORNIA PLZ CREIGHTON UNIVERSITY, CENTER FOR HEALTH & COUNSELING
OMAHA NE
68178-0133
US

V. Phone/Fax

Practice location:
  • Phone: 402-280-2735
  • Fax: 402-280-1859
Mailing address:
  • Phone: 402-280-2735
  • Fax: 402-280-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: