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1790519130
JUSTIN LIEDKE
OMAHA, NE
NPI
1790519130
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: NE 24-373336)
Enumeration Date
2024-08-28
Last Update Date
2024-08-28
Business Address
JUSTIN LIEDKE
6420 S 193RD AVE STE 100
OMAHA, NE 68135-3948
Phone number: 574-387-4313
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Mailing Address
JUSTIN LIEDKE
215 RED COACH DR
MISHAWAKA, IN 46545-8307
Phone number: 574-387-4313
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