Individual
BREONNA JANAE' FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12680 C ST, OMAHA, NE 68144-4071
(402) 598-3502
Mailing address
1515 N 32ND ST, OMAHA, NE 68111-4213
(402) 706-4232
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/06/2025
Last updated
03/08/2025
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