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Individual

DR. LIAM RUSSELL HEERTEN-RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD, MSW, PLMPH

Contact information

Practice address
7701 PACIFIC ST STE 323, OMAHA, NE 68114-5480
(402) 242-4720
Mailing address
4817 CHICAGO ST APT 1, OMAHA, NE 68132-3020
(402) 419-9777

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
7428
NE
1041C0700X
Clinical Social Worker
Primary
12065
NE

Other

Enumeration date
01/08/2020
Last updated
01/08/2020
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