Individual
MRS. TARA ALYSSA SESTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
16529 DREXEL ST, OMAHA, NE 68135-6492
(402) 719-8504
Mailing address
16529 DREXEL ST, OMAHA, NE 68135-6492
(402) 719-8504
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14103653
NE
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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