Provider Demographics
NPI:1013214964
Name:SAHELE, DENISE SNODGRASS (AD)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:SNODGRASS
Last Name:SAHELE
Suffix:
Gender:F
Credentials:AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 SOUTH ST # L7TH
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2743
Mailing Address - Country:US
Mailing Address - Phone:402-441-7940
Mailing Address - Fax:402-441-8625
Practice Address - Street 1:2201 SOUTH ST # 17TH
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2743
Practice Address - Country:US
Practice Address - Phone:402-441-7940
Practice Address - Fax:402-441-8625
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE171M00000XMedicaid