Individual
FEDELINO BARZAGA DIANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2119 E 16TH ST, FREMONT, NE 68025-3705
(402) 708-1646
Mailing address
748 E MILITARY AVE, FREMONT, NE 68025-5183
(402) 708-1646
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/12/2025
Last updated
03/11/2025
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