Provider Demographics
NPI:1609017730
Name:CRIBBS, LAURA LEE (LMT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3280 W POWERS AVE
Mailing Address - Street 2:
Mailing Address - City:BELL
Mailing Address - State:FL
Mailing Address - Zip Code:32619-2403
Mailing Address - Country:US
Mailing Address - Phone:727-247-7627
Mailing Address - Fax:
Practice Address - Street 1:3280 W POWERS AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:FL
Practice Address - Zip Code:32619-2403
Practice Address - Country:US
Practice Address - Phone:727-247-7627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA55252225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist