Provider Demographics
NPI:1669769139
Name:GABBERT, COLLEEN CATHERINE (MS OTR/L)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:CATHERINE
Last Name:GABBERT
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 1:24 WINDSOR PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-5611
Mailing Address - Country:US
Mailing Address - Phone:347-885-7271
Mailing Address - Fax:
Practice Address - Street 1:24 WINDSOR PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5611
Practice Address - Country:US
Practice Address - Phone:347-885-7271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016816-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist