Individual
WENDLAMITA FATIM AIDA OUEDRAOGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6709 S 73RD STREET CIR APT 5, RALSTON, NE 68127-5316
(509) 900-8095
Mailing address
6709 S 73RD STREET CIR APT 5, RALSTON, NE 68127-5316
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NE
Other
Enumeration date
04/18/2024
Last updated
04/18/2024
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