Provider Demographics
NPI:1972086544
Name:LABAYEN, MARIA E (OT)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:E
Last Name:LABAYEN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:E
Other - Last Name:QUIZON-LABAYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OT
Mailing Address - Street 1:25117 SW PARKWAY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070-9697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3301 N MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2014
Practice Address - Country:US
Practice Address - Phone:727-785-8335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist