Provider Demographics
NPI:1326325853
Name:VERMAAS-LEE, JACY (MA, OTR/L)
Entity Type:Individual
Prefix:
First Name:JACY
Middle Name:
Last Name:VERMAAS-LEE
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CALIFORNA PLZ
Mailing Address - Street 2:BOYNE 115F
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68178-0001
Mailing Address - Country:US
Mailing Address - Phone:402-280-5183
Mailing Address - Fax:402-280-5692
Practice Address - Street 1:16910 FRANCES ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68130-2399
Practice Address - Country:US
Practice Address - Phone:402-280-5183
Practice Address - Fax:402-280-5692
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-11
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1292225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist