Provider Demographics
NPI:1588943724
Name:NEUBAUER, COLBY LYNN (OTR/L)
Entity type:Individual
Prefix:
First Name:COLBY
Middle Name:LYNN
Last Name:NEUBAUER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:COLBY
Other - Middle Name:LYNN
Other - Last Name:STOUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 KATHLEEN ST APT 2
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15211-2133
Mailing Address - Country:US
Mailing Address - Phone:724-679-0388
Mailing Address - Fax:
Practice Address - Street 1:2757 LEECHBURG RD
Practice Address - Street 2:
Practice Address - City:LOWER BURRELL
Practice Address - State:PA
Practice Address - Zip Code:15068-3138
Practice Address - Country:US
Practice Address - Phone:724-337-0630
Practice Address - Fax:724-337-0630
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011952225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist