Provider Demographics
NPI:1023871670
Name:KOBA, ANNE PERRI (OTR/L)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:PERRI
Last Name:KOBA
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 1:97 HARVEST WOODS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFALL
Mailing Address - State:CT
Mailing Address - Zip Code:06481-2052
Mailing Address - Country:US
Mailing Address - Phone:860-995-0532
Mailing Address - Fax:
Practice Address - Street 1:1294 MAIN ST #815
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-518-8447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001072225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics