Provider Demographics
NPI:1124270459
Name:APTHORPE, MARY ANGELA (PLADC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANGELA
Last Name:APTHORPE
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 WAGON TRAIN RD
Mailing Address - Street 2:
Mailing Address - City:HICKMAN
Mailing Address - State:NE
Mailing Address - Zip Code:68372-9877
Mailing Address - Country:US
Mailing Address - Phone:402-792-0097
Mailing Address - Fax:402-792-0098
Practice Address - Street 1:9300 WAGON TRAIN RD
Practice Address - Street 2:
Practice Address - City:HICKMAN
Practice Address - State:NE
Practice Address - Zip Code:68372-9877
Practice Address - Country:US
Practice Address - Phone:402-792-0097
Practice Address - Fax:402-792-0098
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-641101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)