Provider Demographics
NPI:1508972886
Name:COBB, REBECCA ANN (PT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:COBB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:SKODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7419 GRANBY ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23505-3406
Mailing Address - Country:US
Mailing Address - Phone:757-489-5820
Mailing Address - Fax:757-489-5822
Practice Address - Street 1:7419 GRANBY ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-3406
Practice Address - Country:US
Practice Address - Phone:757-489-5820
Practice Address - Fax:757-489-5822
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305204673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist