Individual
PRANATHI GANNAVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 REGENCY PKWY, OMAHA, NE 68114-3791
(402) 980-3635
Mailing address
310 REGENCY PKWY, OMAHA, NE 68114-3791
(402) 980-3635
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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