Provider Demographics
NPI:1265272876
Name:DREIBELBIS, MAKAYLA (PTA)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:DREIBELBIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 N WASHINGTON ST FL 2
Mailing Address - Street 2:
Mailing Address - City:LOCK HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17745-3525
Mailing Address - Country:US
Mailing Address - Phone:814-933-8565
Mailing Address - Fax:
Practice Address - Street 1:526 WESTERLY PKWY
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5905
Practice Address - Country:US
Practice Address - Phone:814-996-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI006251225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant