Provider Demographics
NPI:1003643693
Name:CONNER, JULIE (EDS, NCSP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CONNER
Suffix:
Gender:F
Credentials:EDS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 OLD HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-5676
Mailing Address - Country:US
Mailing Address - Phone:402-296-3361
Mailing Address - Fax:
Practice Address - Street 1:1912 OLD HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-5676
Practice Address - Country:US
Practice Address - Phone:402-296-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE20230010931103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool