Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CX0006X | Orientation and Mobility Training Provider | 110684 | IA |
NPI | 1336811066 |
---|---|
Provider Name | Alexis Renee Thomas |
First Address | Omaha, NE 68114-3319 |
Second Address | Omaha, NE 68114-3319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2021 |
Last Update Date | 30/09/2021 |