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General NPI Number Information
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NPI Number | 1902395924
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Entity Type | Organization
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Legal Business Name | BRYCE RIESSLAND COUNSELING LLC
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Dates
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Enumeration Date | 05/04/2018
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 124 W 46TH ST STE 105
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City | KEARNEY
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State | NE
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Zip | 68847-8348
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Country | US
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Telephone | 308-440-0948
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Fax | 308-388-5545
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Provider Business Mailing Address
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Address Line | 32015 HAWK RD
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City | PLEASANTON
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State | NE
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Zip | 68866-3165
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Country | US
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Telephone | 308-440-0948
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Fax | 308-388-5545
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Authorized Official
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Title or Position | COUNSELOR
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Name | BRYCE DONALD RIESSLAND
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Credential |
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Telephone | 308-440-0948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 3527
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License Number State | NE
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