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General NPI Number Information
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NPI Number | 1669123196
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Entity Type | Organization
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Legal Business Name | COUNTY OF OTOE SCHOOL DISTRICT 111
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Dates
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Enumeration Date | 01/17/2022
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 1700 14TH AVE
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City | NEBRASKA CITY
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State | NE
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Zip | 68410-1146
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Country | US
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Telephone | 402-873-6033
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 14TH AVE
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City | NEBRASKA CITY
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State | NE
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Zip | 68410-1146
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Country | US
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Telephone | 402-873-6033
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF STUDENT SERVICES
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Name | JASON HIPPEN
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Credential |
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Telephone | 402-873-6033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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