Provider Demographics
NPI:1205224292
Name:LOOBY, DYANNE P (OTA/L)
Entity Type:Individual
Prefix:MS
First Name:DYANNE
Middle Name:P
Last Name:LOOBY
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33846 BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4144
Mailing Address - Country:US
Mailing Address - Phone:440-655-4887
Mailing Address - Fax:
Practice Address - Street 1:101 S BISSELL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OH
Practice Address - Zip Code:44202-9170
Practice Address - Country:US
Practice Address - Phone:440-424-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH01260374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01260OtherOCCUPATIONAL THERAPY