Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 930 | NE |
NPI | 1245584796 |
---|---|
Provider Name | Ms. Ann Marie Mannschreck |
First Address | Omaha, NE 68135-1241 |
Second Address | Omaha, NE 68144-2424 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2012 |
Last Update Date | 06/11/2012 |