Provider Demographics
NPI:1649549965
Name:EYBERG, CAITLIN ANN (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ANN
Last Name:EYBERG
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 K AND T CIR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MO
Mailing Address - Zip Code:64735-1937
Mailing Address - Country:US
Mailing Address - Phone:573-808-6399
Mailing Address - Fax:
Practice Address - Street 1:1702 K AND T CIR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MO
Practice Address - Zip Code:64735-1937
Practice Address - Country:US
Practice Address - Phone:573-808-6399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007023078225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist