Provider Demographics
NPI:1457946857
Name:BOESIGER, TAMI L (LIMHP, LPC)
Entity Type:Individual
Prefix:
First Name:TAMI
Middle Name:L
Last Name:BOESIGER
Suffix:
Gender:F
Credentials:LIMHP, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 S 105TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-2908
Mailing Address - Country:US
Mailing Address - Phone:402-806-5758
Mailing Address - Fax:
Practice Address - Street 1:11615 I ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-1211
Practice Address - Country:US
Practice Address - Phone:402-513-0148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2639101YP2500X
NE2602101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional