Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 2319 | NE |
NPI | 1669094561 |
---|---|
Provider Name | Timothy G Dunne |
First Address | Omaha, NE 68132-2020 |
Second Address | Omaha, NE 68132-2020 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2020 |
Last Update Date | 13/05/2020 |