Provider Demographics
NPI:1063638658
Name:LEBITA, DESABEL ROMERO (PT)
Entity Type:Individual
Prefix:
First Name:DESABEL
Middle Name:ROMERO
Last Name:LEBITA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 FLETCHER AVE
Mailing Address - Street 2:156
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-1030
Mailing Address - Country:US
Mailing Address - Phone:402-438-0832
Mailing Address - Fax:
Practice Address - Street 1:4405 NORMAL BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5551
Practice Address - Country:US
Practice Address - Phone:402-488-2355
Practice Address - Fax:402-488-2779
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1528225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist