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NPI Code Detail

MEDICARE: KODJOVI DOGBEVI

MEDICARE:   KODJOVI  DOGBEVI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor7651NE
2101YM0800XMental Health Counselor12729NE

General Provider Information

NPI Number : 1134896988
Entity Type Code : Individual
Provider Name (Legal Business Name) : KODJOVI DOGBEVI
Provider Business Mailing Address
First Line : 11605 MIRACLE HILLS DR STE 300
Second Line :
City : OMAHA
State : NE
Zip : 68154-4467
Country : US
Telephone Number : 402-238-1431
Fax Number : 402-281-1862
Provider Business Practice Location Address
First Line : 1941 S 42ND ST STE 328
Second Line :
City : OMAHA
State : NE
Zip : 68105-2943
Country : US
Telephone Number : 402-614-8444
Fax Number : 402-614-8443
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/27/2021
Last Update Date : 06/08/2026

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Directions to “ KODJOVI DOGBEVI ” Practice Location

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