Individual
LATECIA MARIE GRIXBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11340 BLONDO ST, OMAHA, NE 68164-3815
(402) 444-6136
Mailing address
2856 PRATT ST, OMAHA, NE 68111-2977
(402) 541-4861
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/28/2025
Last updated
02/28/2025
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