Individual
ANN M PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
11163 HANOVER ST, OMAHA, NE 68142-1519
(402) 496-6396
Mailing address
11163 HANOVER ST, OMAHA, NE 68142-1519
(402) 496-6396
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1155
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025593900
—
NE
Enumeration date
04/28/2006
Last updated
02/19/2008
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