Provider Demographics
NPI:1780641258
Name:GREINER, BOBBI S (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:S
Last Name:GREINER
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10601 S. 72ND ST.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PAPILLION
Mailing Address - State:NE
Mailing Address - Zip Code:68046-3408
Mailing Address - Country:US
Mailing Address - Phone:402-932-2782
Mailing Address - Fax:402-932-2705
Practice Address - Street 1:10601 S. 72ND ST.
Practice Address - Street 2:SUITE 103
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-3408
Practice Address - Country:US
Practice Address - Phone:402-932-2782
Practice Address - Fax:402-932-2705
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1216225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47065477701Medicaid