Provider Demographics
NPI:1851720080
Name:KNEZEVIC, BRANISLAVA (PHD, LMHP)
Entity Type:Individual
Prefix:DR
First Name:BRANISLAVA
Middle Name:
Last Name:KNEZEVIC
Suffix:
Gender:F
Credentials:PHD, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 N 13TH ST
Mailing Address - Street 2:UNIT 4
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2592
Mailing Address - Country:US
Mailing Address - Phone:712-253-1687
Mailing Address - Fax:
Practice Address - Street 1:1310 N 13TH ST
Practice Address - Street 2:UNIT 4
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-2592
Practice Address - Country:US
Practice Address - Phone:712-253-1687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health