NPI 1073900528 · live from the CMS NPI Registry
Andrea Avila, JD, PhD
Psychologist, Clinical in Lincoln, NE. National Provider Identifier 1073900528, active.
NPI record
| NPI | 1073900528 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 2000 P St, Lincoln, NE 68503 |
| Practice phone | 402-413-5636 |
| Mailing address | 2355 State St Ste 101, Salem, OR 97301 |
| Enumerated | April 22, 2015 |
| Last updated | August 7, 2023 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Forensic | 103TF0200X | 1027 (NE) |
| Psychologist, Clinical primary | 103TC0700X | 1027 (NE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.