| Amy Johanna Sjoholm, Llc | |
|
3308 W Capital Ave Grand Island NE 68803-1333 | |
| (402) 879-5755 | |
| Not Available |
| Full Name | Amy Johanna Sjoholm, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3308 W Capital Ave, Grand Island, Nebraska |
| Authorized Official Name and Position | Amy Johanna Sjoholm (OWNER) |
| Authorized Official Contact | 4028795755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy Johanna Sjoholm, Llc 106 Parklane Ave Aurora NE 68818-1844 Ph: (402) 879-5755 | Amy Johanna Sjoholm, Llc 3308 W Capital Ave Grand Island NE 68803-1333 Ph: (402) 879-5755 |
| NPI Number | 1538512876 |
|---|---|
| Provider Enumeration Date | 07/21/2016 |
| Last Update Date | 07/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538512876 | NPI | - | NPPES |
| 10026475600 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 4454 (Nebraska) | Primary |
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