Individual
DECEMBER PAW PWEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1913 SW 11TH ST LOT 199, LINCOLN, NE 68522-1666
(801) 759-7175
Mailing address
4911 N 64TH ST, OMAHA, NE 68104-1908
(402) 609-6645
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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