Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 400 | NE |
Y | 103TC0700X | Clinical Psychologist | 400 | NE |
N | 102L00000X | Psychologist | 400 | NE |
N | 103T00000X | Psychologist | 400 | NE |
N | 103TA0700X | Adult Development & Aging Psychologist | 400 | NE |
N | 103G00000X | Clinical Psychologist | 400 | NE |
N | 103TC0700X | Clinical Psychologist | 400 | NE |
N | 103TC1900X | Counseling Psychologist | 400 | NE |
N | 103TF0000X | Family Psychologist | 400 | NE |
N | 103TF0200X | Forensic Psychologist | 400 | NE |
N | 103TH0100X | Health Service | 400 | NE |
N | 103TR0400X | Rehabilitation Psychologist | 400 | NE |
NPI | 1649310467 |
---|---|
Provider Name | Dr. Marjorie A Padula |
First Address | Omaha, NE 68127-0034 |
Second Address | Omaha, NE 68137-3679 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2007 |
Last Update Date | 02/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
08209 | BLUE CROSS BLUE SHIELD (01) | NE |
10024948300 | (05) | NE |
47085691100 | (05) | NE |
8180 | MIDLANDS CHOICE (01) | NE |
S07828 | (02) | NE |