Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4212 | CT |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 4212 | CT |
NPI | 1326466434 |
---|---|
Provider Name | Rebecca Lobdell |
First Address | Shelton, CT 06484-3528 |
Second Address | Bridgeport, CT 06610-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2014 |
Last Update Date | 04/04/2014 |