Provider Demographics
NPI:1952534174
Name:BALDONADO, MORGAN RAE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:RAE
Last Name:BALDONADO
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 DODGE ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-1937
Mailing Address - Country:US
Mailing Address - Phone:402-314-5338
Mailing Address - Fax:
Practice Address - Street 1:7111 STEPHANIE LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-5300
Practice Address - Country:US
Practice Address - Phone:402-420-0003
Practice Address - Fax:402-486-7751
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2337225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist