Individual
DR. MICHAEL ROBERT NEISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
809 S 174TH ST, OMAHA, NE 68118-3540
(402) 991-8093
Mailing address
809 S 174TH ST, OMAHA, NE 68118-3540
(402) 991-8093
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
262
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025122400
—
NE
05
—
10025263600
—
NE
Enumeration date
06/12/2006
Last updated
07/16/2014
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