Individual
TRISTAN SOPHIA PETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1145 HIGH ST, LINCOLN, NE 68502-4440
(402) 423-6464
Mailing address
1145 HIGH ST, LINCOLN, NE 68502-4440
(402) 423-6464
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-19-98934
NE
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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