Individual
SAMANTHA WREN ZICKEFOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3822 CHICAGO ST, OMAHA, NE 68131-2319
(402) 612-9468
Mailing address
3822 CHICAGO ST, OMAHA, NE 68131-2319
(402) 612-9468
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12131266
NE
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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