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Individual

MRS. JODI LYNN GUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
4101 WOOLWORTH AVE, OT/PT GYM 4TH FLOOR, OMAHA, NE 68105-1850
(402) 995-3648
Mailing address
6332 POPPLETON AVE, OMAHA, NE 68106-1540
(402) 554-0845

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
001861
IA
225X00000X
Occupational Therapist
Primary
926
NE

Other

Enumeration date
03/29/2009
Last updated
03/29/2009
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