Individual
JENNIFER CORDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3226 S 112TH ST, OMAHA, NE 68144-4708
(402) 660-0946
Mailing address
PO BOX 45169, OMAHA, NE 68145-0169
(402) 660-0946
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
401
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91182814501
—
NE
Enumeration date
04/27/2011
Last updated
04/27/2011
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