Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics |
NPI | 1013388230 |
---|---|
Provider Name | Margaret Hebenstreit |
First Address | Omaha, NE 68137-2648 |
Second Address | Omaha, NE 68137-2648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2015 |
Last Update Date | 14/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
496 | NE STATE LICENSE (01) | NE |