Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1590 | NE |
NPI | 1003167842 |
---|---|
Provider Name | Ms. Roxanne Lorrain Augeri |
First Address | Lincoln, NE 68516 |
Second Address | Omaha, NE 68105-1803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2012 |
Last Update Date | 19/09/2012 |