Healthcare Provider Details

I. General information

NPI: 1316883580
Provider Name (Legal Business Name): MARY LOUISE TOHOUEGNON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9411 F ST
OMAHA NE
68127-1215
US

IV. Provider business mailing address

9411 F ST
OMAHA NE
68127-1215
US

V. Phone/Fax

Practice location:
  • Phone: 531-867-8419
  • Fax:
Mailing address:
  • Phone: 531-867-8419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: