Provider Demographics
NPI:1174297444
Name:GOEBEL, AUBREY MORGAN (OTR, L)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:MORGAN
Last Name:GOEBEL
Suffix:
Gender:F
Credentials:OTR, L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 ALLYN DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IN
Mailing Address - Zip Code:47620-1101
Mailing Address - Country:US
Mailing Address - Phone:812-306-8127
Mailing Address - Fax:
Practice Address - Street 1:1825 ALLYN DR
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IN
Practice Address - Zip Code:47620-1101
Practice Address - Country:US
Practice Address - Phone:812-306-8127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY270995225X00000X
IN31007419A225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist