Basic Information
| Provider Information | |||||||||
| NPI: | 1275924011 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIGBY | ||||||||
| FirstName: | JAIMIE | ||||||||
| MiddleName: | KAY | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 985450 NEBRASKA MEDICAL CTR | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681985450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025598863 | ||||||||
| FaxNumber: | 4025595737 | ||||||||
| Practice Location | |||||||||
| Address1: | 444 S 44TH ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681313727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025598863 | ||||||||
| FaxNumber: | 4025595737 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2015 | ||||||||
| LastUpdateDate: | 05/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | 1-20-40737 | NE | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 106S00000X | N |
No ID Information.