Individual
AYISSATOU ESSOBOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9706 JEFFERSON PLZ, OMAHA, NE 68127-3269
(402) 557-8583
(402) 991-5070
Mailing address
9706 JEFFERSON PLZ, OMAHA, NE 68127-3269
(531) 375-1848
(402) 991-5070
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
NE
Other
Enumeration date
02/12/2025
Last updated
02/12/2025
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