Doctor Name: | MR. JESSE EDWARD FLORANG |
NPI Number: | 1124351648 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHP |
License Number: | 3924 |
Business Practice Address: | 6812 M Ave Kearney, NE - 688471547 |
Business Phone Number: | 4026169842 |
Business Fax Number: | |
Mailing Address: | 6812 M Ave, KEARNEY |
State: | NE |
Postal Code: | 688471547 |
Phone Number: | 4026169842 |
Fax Number: | |
NPI Enumeration Date: | 09/16/2009 |
NPI Last Update Date: | 09/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 3924 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |