Provider Demographics
NPI:1639728132
Name:LEFEBVRE, ANTEA GRACE NICOLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANTEA
Middle Name:GRACE NICOLE
Last Name:LEFEBVRE
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 1:450 BEGEMAN RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-9246
Mailing Address - Country:US
Mailing Address - Phone:251-366-3977
Mailing Address - Fax:
Practice Address - Street 1:WILLIAM F. GREEN STATE VETERANS HOME
Practice Address - Street 2:300 FAULKNER DRIVE
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507
Practice Address - Country:US
Practice Address - Phone:251-937-8049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4993225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist