Healthcare Provider Details
I. General information
NPI: 1780641258
Provider Name (Legal Business Name): BOBBI S GREINER OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/28/2006
Last Update Date: 02/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10601 S. 72ND ST. SUITE 103
PAPILLION NE
68046-3408
US
IV. Provider business mailing address
10601 S. 72ND ST. SUITE 103
PAPILLION NE
68046-3408
US
V. Phone/Fax
- Phone: 402-932-2782
- Fax: 402-932-2705
- Phone: 402-932-2782
- Fax: 402-932-2705
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | 1216 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XP0200X |
| Taxonomy | Pediatric Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: