Provider Demographics
NPI:1831641547
Name:HERBIG, LOUISE (COTA-L)
Entity Type:Individual
Prefix:
First Name:LOUISE
Middle Name:
Last Name:HERBIG
Suffix:
Gender:F
Credentials:COTA-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1819 EAGLE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:NE
Mailing Address - Zip Code:68873-3443
Mailing Address - Country:US
Mailing Address - Phone:308-379-2857
Mailing Address - Fax:
Practice Address - Street 1:1405 HERITAGE DR
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:NE
Practice Address - Zip Code:68873-3618
Practice Address - Country:US
Practice Address - Phone:308-754-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-28
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE967224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant