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General NPI Number Information
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NPI Number | 1366581126
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Entity Type | Individual
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Provider Name | SUE ELLEN HIEB PLADC
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2116 W FAIDLEY AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4645
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Country | US
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Telephone | 308-398-5431
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Fax | 308-398-5404
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Provider Business Mailing Address
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Address Line | 708 N CUSTER AVE
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4310
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Country | US
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Telephone | 308-389-6167
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | P496
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License Number State | NE
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