Provider Demographics
NPI:1588958318
Name:TABER, ELIZABETH (OT)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:TABER
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 1:45 ELM ST
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2305
Mailing Address - Country:US
Mailing Address - Phone:860-529-8661
Mailing Address - Fax:860-563-6639
Practice Address - Street 1:45 ELM ST
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2305
Practice Address - Country:US
Practice Address - Phone:860-529-8661
Practice Address - Fax:860-563-6639
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist