Organization
SARA PATTAVINA MOULTON, LIMHP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA E PATTAVINA MOULTON (PRESIDENT)
(402) 312-0177
Entity
Organization
Contact information
Practice address
1804 S 116TH ST, OMAHA, NE 68144-2902
(402) 312-0177
(402) 939-0141
Mailing address
1804 S 116TH ST, OMAHA, NE 68144-2902
(402) 312-0177
(402) 939-0141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026137800
—
NE
Enumeration date
11/08/2011
Last updated
08/11/2021
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