Provider Demographics
NPI:1285480442
Name:KOBZA, ALYSSA KAY
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KAY
Last Name:KOBZA
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 1:400 N 48TH ST STE C1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-3402
Mailing Address - Country:US
Mailing Address - Phone:402-318-5559
Mailing Address - Fax:
Practice Address - Street 1:400 N 48TH ST STE C1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-3402
Practice Address - Country:US
Practice Address - Phone:402-318-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician