Provider Demographics
NPI:1154702801
Name:MAHRT, KIRSTEN EMMA
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:EMMA
Last Name:MAHRT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 W GARY GATELY ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68528-1716
Mailing Address - Country:US
Mailing Address - Phone:402-760-2528
Mailing Address - Fax:
Practice Address - Street 1:5760 S 86TH DR # 2
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9247
Practice Address - Country:US
Practice Address - Phone:402-484-0326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2498235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist