Healthcare Provider Details

I. General information

NPI: 1952812315
Provider Name (Legal Business Name): ARIEL O'DOHERTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 REGENCY PKWY STE 115
OMAHA NE
68114-3702
US

IV. Provider business mailing address

4433 S 70TH ST STE 200
LINCOLN NE
68516-4275
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-5251
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0746
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: