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General NPI Number Information
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NPI Number | 1356424725
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Entity Type | Organization
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Legal Business Name | PSYCHOTHERAPY, INC.
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Dates
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Enumeration Date | 10/22/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1001 S 70TH ST SUITE 107
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City | LINCOLN
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State | NE
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Zip | 68510-7905
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Country | US
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Telephone | 402-488-7759
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Fax | 402-488-7784
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Provider Business Mailing Address
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Address Line | 1001 S 70TH ST SUITE 107
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City | LINCOLN
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State | NE
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Zip | 68510-7905
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Country | US
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Telephone | 402-488-7759
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Fax | 402-488-7784
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | MS. DORIE D. REED
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Credential | PH.D.
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Telephone | 402-488-7759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 326
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License Number State | NE
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