Individual
ELISE SUSANNAH KALDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10717 VIRGINIA PLZ STE 113, LA VISTA, NE 68128-3255
(402) 926-4373
Mailing address
13829 MARINDA CIR, OMAHA, NE 68144-2453
(402) 885-5180
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-360847
NE
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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