Individual
MARY WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7805 L ST STE 140, OMAHA, NE 68127-1870
(531) 375-1013
Mailing address
7805 L ST STE 140, OMAHA, NE 68127-1870
(531) 375-1013
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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