Individual
DIANE MARIE MCKIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7105 S 83RD ST APT 2, LAVISTA, NE 68128-2195
(402) 502-2703
Mailing address
7105 S 83RD ST APT 2, LAVISTA, NE 68128-2195
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
272
NE
Other
Enumeration date
03/03/2008
Last updated
03/03/2008
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