Grandy, Thomas Gerard

Grandy, Thomas Gerard is an sole proprietor health care provider with primary practice located at 706 N. 129Th Street Suite 114, Omaha NE 68154. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Grandy, Thomas Gerard can be contacted via phone (402) 301-4587.

Contact Information

Primary practice address
706 N. 129Th Street Suite 114 Omaha NE 68154
Fax: (402) 445-8892
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 95 Nebraska

Profile Details

NPI number 1053485821
LBN Legal business name Grandy, Thomas Gerard
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 20th, 2006
Last updated Aug 8th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053485821 NPPES
Nebraska MEDICAID 47069167300

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