Provider Demographics
NPI:1710232608
Name:HEBNER, AMANDA JO (PLMHP)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:HEBNER
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10748 VIRGINIA PLZ,
Mailing Address - Street 2:SUITE 107
Mailing Address - City:LAVISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-3204
Mailing Address - Country:US
Mailing Address - Phone:402-933-4411
Mailing Address - Fax:
Practice Address - Street 1:10748 VIRGINIA PLZ
Practice Address - Street 2:SUITE 107
Practice Address - City:LAVISTA
Practice Address - State:NE
Practice Address - Zip Code:68128-3204
Practice Address - Country:US
Practice Address - Phone:402-933-4411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health