Provider Demographics
NPI:1669202974
Name:AMEEN WAHBA PSYCHOTHERAPY
Entity type:Organization
Organization Name:AMEEN WAHBA PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE
Authorized Official - Prefix:
Authorized Official - First Name:AMEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAHBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-832-0152
Mailing Address - Street 1:3010 LINCOLN BLVD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-1437
Mailing Address - Country:US
Mailing Address - Phone:484-832-0152
Mailing Address - Fax:
Practice Address - Street 1:2126 N 117TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3670
Practice Address - Country:US
Practice Address - Phone:484-832-0152
Practice Address - Fax:402-934-5228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health