Individual
BANTWESA MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4606 N 56TH ST, OMAHA, NE 68104-2270
(402) 933-0680
Mailing address
PO BOX 939, BELLEVUE, NE 68005-0939
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/26/2025
Last updated
08/26/2025
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