Provider Demographics
NPI:1962890194
Name:CIBOREK, VICKI (COTA/L)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:
Last Name:CIBOREK
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:VICKI
Other - Middle Name:
Other - Last Name:GEIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:140 BERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:MUNROE FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44262-1104
Mailing Address - Country:US
Mailing Address - Phone:330-800-8921
Mailing Address - Fax:
Practice Address - Street 1:140 BERMONT AVE
Practice Address - Street 2:
Practice Address - City:MUNROE FALLS
Practice Address - State:OH
Practice Address - Zip Code:44262-1104
Practice Address - Country:US
Practice Address - Phone:330-800-8921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-22
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1306224Z00000X
OH007525224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant