Healthcare Provider Details

I. General information

NPI: 1336671783
Provider Name (Legal Business Name): RACHEL BEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 04/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S 135TH AVE
OMAHA NE
68144-2424
US

IV. Provider business mailing address

17220 GRAND AVE
OMAHA NE
68116-1101
US

V. Phone/Fax

Practice location:
  • Phone: 402-333-2304
  • Fax: 402-330-1428
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number729
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: