Individual
TYREESHA DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1209 HARNEY ST STE 105, OMAHA, NE 68102-1838
(402) 252-8181
Mailing address
11408 CAMDEN AVE, OMAHA, NE 68164-2029
(531) 210-9270
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-282145
NE
Other
Enumeration date
07/03/2023
Last updated
07/03/2023
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