Provider Demographics
NPI:1063772457
Name:FALB, LINDA STEPHANIE (OT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:STEPHANIE
Last Name:FALB
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 BEAR MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-6817
Mailing Address - Country:US
Mailing Address - Phone:303-954-9793
Mailing Address - Fax:
Practice Address - Street 1:1750 BEAR MOUNTAIN DRIVE
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80305-6817
Practice Address - Country:US
Practice Address - Phone:303-954-9793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2667225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation