Individual
ATHENA KOUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6420 S 193RD AVE STE 100, OMAHA, NE 68135-3948
(574) 387-4313
Mailing address
215 RED COACH DR, MISHAWAKA, IN 46545-8307
(574) 287-4313
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
24375107
NE
Other
Enumeration date
09/06/2024
Last updated
01/09/2025
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