Provider Demographics
NPI:1659541852
Name:SOTO, BRANDY (LIMHP, LISW)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:SOTO
Suffix:
Gender:F
Credentials:LIMHP, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1024 TEKAMAH LN
Mailing Address - Street 2:
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-6244
Mailing Address - Country:US
Mailing Address - Phone:402-350-4979
Mailing Address - Fax:
Practice Address - Street 1:900 S 74TH PLZ STE 400
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4667
Practice Address - Country:US
Practice Address - Phone:402-800-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8406101YM0800X
NE1269101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health