Individual
KOSSI A DJISSENOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1299 FARNAM ST STE 300, OMAHA, NE 68102-1857
(402) 813-4937
Mailing address
14471 SAHLER PLZ APT 105, OMAHA, NE 68116-6015
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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