Dominic Evin Groenhagen-Bolden
Adult Companion in Omaha, NE. Individual provider (NPI-1).
NPI number1831987239
StatusActive
Last updated in NPPESApr 27, 2026
Details
- NPI
- 1831987239
- Entity type
- Individual (NPI-1)
- Name
- Dominic Evin Groenhagen-Bolden
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 28, 2025
- Certification date
- Apr 27, 2026
- Last updated
- Apr 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 372600000X | Adult Companion | – | – | Yes |
Practice location
5155 S 124th AveOmaha, NE 68137-2128
Phone 402-690-8045
Mailing address
5155 S 124th AveOmaha, NE 68137-2128
Phone 402-690-8045
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