Individual
GRACE MADSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8922 CUMING ST, OMAHA, NE 68114-2732
(402) 926-4373
Mailing address
9950 S 35TH PLZ APT 4208, BELLEVUE, NE 68123-2306
(402) 975-9230
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
20144245
NE
Other
Enumeration date
11/11/2020
Last updated
11/11/2020
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