Individual
DENISE FANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT RET.
Contact information
Practice address
1415 HARNEY ST, SUITE, OMAHA, NE 68102-2250
(402) 559-0091
Mailing address
3315 N 124TH ST, OMAHA, NE 68164-2573
(402) 651-5088
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
235500000X
Speech/Language/Hearing Specialist/Technologist
16
NE
Other
Enumeration date
03/09/2006
Last updated
01/03/2019
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