| Doctor Name: | JOLYNN LIDDICK |
| NPI Number: | 1740681865 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PLMHP, PLADC |
| License Number: | 10294 |
| Business Practice Address: | 2302 8th Ave Suite 5 Plattsmouth, NE - 680482365 |
| Business Phone Number: | 4029800858 |
| Business Fax Number: | |
| Mailing Address: | 2302 8th Ave, Suite 5 PLATTSMOUTH |
| State: | NE |
| Postal Code: | 680482365 |
| Phone Number: | 4029800858 |
| Fax Number: | |
| NPI Enumeration Date: | 09/08/2014 |
| NPI Last Update Date: | 10/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 10294 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |