Individual
ISHAWNA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1299 FARNAM ST STE 300, OMAHA, NE 68102-1857
(402) 969-6633
Mailing address
5105 BEDFORD AVE, OMAHA, NE 68104-3546
(531) 299-2460
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
03/03/2023
Last updated
01/02/2025
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