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Individual

TIKABOGLABA BALETARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5020 COPPER CREEK RD, BELLEVUE, NE 68157-2906
(402) 980-5622
Mailing address
4715 S 132ND ST, OMAHA, NE 68137-1899

Taxonomy

Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
3747A0650X
Attendant Care Provider

Other

Enumeration date
03/04/2025
Last updated
03/04/2025
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