Organization
MISSION MIDDLE SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBERTA ANN MULROY (SPEECH LANGUAGE PATHOLOGIST)
(402) 293-4260
Entity
Organization
Contact information
Practice address
2201 WASHINGTON ST, BELLEVUE, NE 68005
(402) 293-4260
Mailing address
2201 WASHINGTON ST, BELLEVUE, NE 68005
(402) 293-4260
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009002007
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009002007
TEACHING CERTIFICAT NUMBER
NE
Enumeration date
11/01/2013
Last updated
11/01/2013
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