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General NPI Number Information
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NPI Number | 1295092534
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Entity Type | Individual
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Provider Name | MARYSOL CAZARES PLMHP, PLADC
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Gender | Female
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 1244 MAIN AVE
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City | CRETE
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State | NE
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Zip | 68333-2260
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Country | US
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Telephone | 402-937-0281
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Fax |
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Provider Business Mailing Address
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Address Line | 1244 MAIN AVE
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City | CRETE
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State | NE
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Zip | 68333-2260
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Country | US
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Telephone | 402-937-0281
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P-149712956
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License Number State | NE
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