Individual
DR. MARJORIE A PADULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
11330 Q ST, OMAHA, NE 68137-3679
(402) 955-2884
Mailing address
PO BOX 27034, OMAHA, NE 68127-0034
(402) 955-2884
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
400
NE
103T00000X
Psychologist
400
NE
103TA0700X
Adult Development & Aging Psychologist
400
NE
103TC0700X
Clinical Psychologist
400
NE
103TC1900X
Counseling Psychologist
400
NE
103TF0000X
Family Psychologist
400
NE
103TF0200X
Forensic Psychologist
400
NE
103TH0100X
Health Service Psychologist
400
NE
103TR0400X
Rehabilitation Psychologist
400
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08209
BLUE CROSS BLUE SHIELD
NE
05
—
10024948300
—
NE
05
—
47085691100
—
NE
01
—
8180
MIDLANDS CHOICE
NE
Enumeration date
02/08/2007
Last updated
10/02/2012
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