MEDICARE: MS. TARA CHRISTINE GARNEAU OTR/L

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
1	225X00000X	Occupational Therapist	1358	NE

General Provider Information

NPI Number	:	1235396540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TARA CHRISTINE GARNEAU OTR/L

Provider Business Mailing Address
First Line	:	541 BROOKSIDE DR
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68528-1016
Country	:	US
Telephone Number	:	402-326-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	2550 SUPERIOR ST
Second Line	:	SUITE 160
City	:	LINCOLN
State	:	NE
Zip	:	68521-4155
Country	:	US
Telephone Number	:	402-742-7400
Fax Number	:	402-742-9592

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2008
Last Update Date	:	10/08/2008

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