Provider Demographics
NPI:1205238664
Name:LEARNING AGENCY- ESU #1
Entity type:Organization
Organization Name:LEARNING AGENCY- ESU #1
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SLP
Authorized Official - Phone:402-369-4291
Mailing Address - Street 1:84987 585TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENDER
Mailing Address - State:NE
Mailing Address - Zip Code:68047-4017
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:211 10TH ST
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:NE
Practice Address - Zip Code:68784-5014
Practice Address - Country:US
Practice Address - Phone:402-287-2061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2013000533251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)