Provider Demographics
NPI:1952286320
Name:ROTHANZL, KERRI (EDS, NCSP)
Entity type:Individual
Prefix:MS
First Name:KERRI
Middle Name:
Last Name:ROTHANZL
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 1:2908 VANDENBERG AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1604
Mailing Address - Country:US
Mailing Address - Phone:402-293-4795
Mailing Address - Fax:
Practice Address - Street 1:2908 VANDENBERG AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68123-1604
Practice Address - Country:US
Practice Address - Phone:402-293-4795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool