Individual
LANISHA MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
8936 N 78TH AVENUE CIR, OMAHA, NE 68122-4109
(469) 668-5005
Mailing address
8936 N 78TH AVENUE CIR, OMAHA, NE 68122-4109
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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