Individual
KELSY WEIDENBACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
718 W G ST, OGALLALA, NE 69153-1348
(308) 289-4103
Mailing address
718 W G ST, OGALLALA, NE 69153-1348
(308) 289-4103
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-375036
NE
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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