Individual
PREMALA T MENEZES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3410 FUTURES DR, SOUTH SIOUX CITY, NE 68776-3917
(402) 412-4271
(402) 412-4296
Mailing address
3410 FUTURES DR, SOUTH SIOUX CITY, NE 68776-3917
(402) 412-4271
(402) 412-4296
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
158
IA
225X00000X
Occupational Therapist
231
SD
225X00000X
Occupational Therapist
Primary
358
NE
Other
Enumeration date
06/23/2006
Last updated
07/08/2007
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