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General NPI Number Information
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NPI Number | 1447537220
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Entity Type | Organization
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Legal Business Name | SARA PATTAVINA MOULTON, LIMHP, P.C.
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Dates
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Enumeration Date | 11/08/2011
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1804 S 116TH ST
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City | OMAHA
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State | NE
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Zip | 68144-2902
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Country | US
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Telephone | 402-312-0177
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Fax | 402-939-0141
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Provider Business Mailing Address
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Address Line | 1804 S 116TH ST
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City | OMAHA
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State | NE
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Zip | 68144-2902
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Country | US
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Telephone | 402-312-0177
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Fax | 402-939-0141
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARA E PATTAVINA MOULTON
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Credential |
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Telephone | 402-312-0177
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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