Individual
TARYAM WILY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8208 S 90TH PLZ APT 1, LA VISTA, NE 68128-4004
(929) 426-3720
Mailing address
6818 GROVER ST STE 200, OMAHA, NE 68106-3632
(402) 932-0072
(402) 614-8245
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
376J00000X
Homemaker
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
03/12/2025
Last updated
03/12/2025
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