Provider Demographics
NPI:1215367586
Name:KESTEL, TERA (MS)
Entity Type:Individual
Prefix:MS
First Name:TERA
Middle Name:
Last Name:KESTEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4060 VINTON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68105-3862
Mailing Address - Country:US
Mailing Address - Phone:402-504-1950
Mailing Address - Fax:866-295-7627
Practice Address - Street 1:4060 VINTON ST
Practice Address - Street 2:SUITE 100
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-3862
Practice Address - Country:US
Practice Address - Phone:402-504-1950
Practice Address - Fax:866-295-7627
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health