Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 2815 | NE |
NPI | 1013140565 |
---|---|
Provider Name | Danielle R Thiessen |
First Address | Papillion, NE 68046-3408 |
Second Address | Papillion, NE 68046-3408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2009 |
Last Update Date | 11/03/2020 |