NPI 1285624262 · live from the CMS NPI Registry
55 Mdos
Psychologist, Clinical in Offutt A F B, NE. National Provider Identifier 1285624262, active.
NPI record
| NPI | 1285624262 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 55 Mdos Sgo, 2501 Capehart Rd, Offutt A F B, NE 68113 |
| Practice phone | 402-294-7883 |
| Enumerated | October 21, 2005 |
| Last updated | June 13, 2008 |
| Authorized official | Stephen Hamilton, Menal Health Flight Commander |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychologist, Clinical primary | 103TC0700X | 679 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.