Healthcare Provider Details

I. General information

NPI: 1881375251
Provider Name (Legal Business Name): CATHERYN KEITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4102 WOOLWORTH AVE
OMAHA NE
68105-1851
US

IV. Provider business mailing address

4102 WOOLWORTH AVE
OMAHA NE
68105-1851
US

V. Phone/Fax

Practice location:
  • Phone: 402-444-7931
  • Fax:
Mailing address:
  • Phone: 402-444-7931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3150
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: