Healthcare Provider Details
I. General information
NPI: 1992735179
Provider Name (Legal Business Name): LEAANN MARIE LAPE-BRINKMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/04/2006
Last Update Date: 02/12/2024
Certification Date: 02/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
12001 Q ST
OMAHA NE
68137-3542
US
IV. Provider business mailing address
12001 Q ST
OMAHA NE
68137-3542
US
V. Phone/Fax
- Phone: 402-592-0328
- Fax: 402-592-4170
- Phone: 402-592-0328
- Fax: 402-592-4170
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | 537 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: