MEDICARE: MS. JULINE MOSSER LIMHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1804	NE

General Provider Information

NPI Number	:	1366834095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULINE MOSSER LIMHP

Provider Business Mailing Address
First Line	:	3610 N 163RD PLZ
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68116-2164
Country	:	US
Telephone Number	:	402-534-1602
Fax Number	:

Provider Business Practice Location Address
First Line	:	3610 N 163RD PLZ
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68116-2164
Country	:	US
Telephone Number	:	402-885-9772
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2015
Last Update Date	:	03/09/2022

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