Individual
TRACI DAWN GUDENRATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7304 S 169TH ST, OMAHA, NE 68136-4168
(402) 932-3072
Mailing address
7304 S 169TH ST, OMAHA, NE 68136-4168
(402) 932-3072
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
001828
IA
235Z00000X
Speech-Language Pathologist
Primary
889
NE
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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