Individual
SARA E PATTAVINA MOULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 S 116TH ST, OMAHA, NE 68144-2902
(402) 312-0177
Mailing address
1804 S 116TH ST, OMAHA, NE 68144-2902
(402) 312-0177
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3067
NE
Other
Enumeration date
12/11/2006
Last updated
08/11/2021
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