Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 1171 | NE |
NPI | 1003467150 |
---|---|
Provider Name | Teresa S Dunning |
First Address | Omaha, NE 68114-5411 |
Second Address | Omaha, NE 68114-5411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2019 |
Last Update Date | 20/09/2019 |