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Individual

CARNELL WATT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1941 S 42ND ST STE 402A, OMAHA, NE 68105-2944
(833) 214-0277
Mailing address
1805 N 73RD ST, OMAHA, NE 68114-1905
(402) 557-8583

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
02/10/2025
Last updated
02/19/2025
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