Individual
JENNA MASERANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1435 TOLEDO ST, SIDNEY, NE 69162-2166
(308) 254-4756
Mailing address
563 BEVERLY RD, SIDNEY, NE 69162-1765
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.0000657
CO
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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