Provider Demographics
NPI:1760967566
Name:COBBLE, BRITTNEY NICOLE (OTD, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:BRITTNEY
Middle Name:NICOLE
Last Name:COBBLE
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1404 WINDLE COMMUNITY RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:38570-6144
Mailing Address - Country:US
Mailing Address - Phone:931-319-9617
Mailing Address - Fax:
Practice Address - Street 1:825 FISHER AVE
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-2140
Practice Address - Country:US
Practice Address - Phone:615-597-4284
Practice Address - Fax:615-597-0739
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6038225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6038OtherTN BOARD OF OCCUPATIONAL THERAPY