Individual
MICHELLE THEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1200 PROVIDENCE RD, WAYNE, NE 68787
(402) 375-7937
Mailing address
1200 PROVIDENCE RD, WAYNE, NE 68787-1212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
391
NE
Other
Enumeration date
05/16/2012
Last updated
07/10/2018
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