Provider Demographics
NPI:1972237618
Name:COSBY ALBERTS, COBYE WYNETTE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:COBYE
Middle Name:WYNETTE
Last Name:COSBY ALBERTS
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 1:336 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1368
Mailing Address - Country:US
Mailing Address - Phone:602-419-5287
Mailing Address - Fax:
Practice Address - Street 1:336 COUNTRY CLUB BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-1368
Practice Address - Country:US
Practice Address - Phone:602-419-5287
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-10
Last Update Date:2022-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA9598225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist