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DR. IBUKUNOLA CHARLES JEGEDE PH.D.

Clinical Neuropsychologist

Omaha, Nebraska

Provider NPI: 1508087206

Provider Information:
DR. IBUKUNOLA CHARLES JEGEDE PH.D.
Gender: M
Not Sole Proprietor

Practice Location:
17500 BURKE ST  OMAHA, NE 68118 US
Tel: 402-401-3566  Fax: --

Business Mailing Address:
17500 BURKE ST  OMAHA, NE 68118 US
Tel: 402-401-3566  Fax: --

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
NE561

Other Provider Identifiers:

IssuerNumberStateType
1417045642NE05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS NE - Page 1



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