Individual
MRS. JESSICA C SOUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14856 SHIRLEY ST, OMAHA, NE 68144-2063
(402) 676-9976
Mailing address
14856 SHIRLEY ST, OMAHA, NE 68144-2063
(402) 676-9976
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
385H00000X
Respite Care
Primary
—
—
Other
Enumeration date
02/24/2025
Last updated
02/24/2025
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